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NPI Code Detail

MEDICARE: JESSICA CAO

MEDICARE: JESSICA CAO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0019XPhysical Rehabilitation Occupational Therapist0210501NY
2225X00000XOccupational Therapist21003FL

General Provider Information

NPI Number : 1912432220
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CAO
Provider Business Mailing Address
First Line : 7616 W COURTNEY CAMPBELL CSWY UNIT 251
Second Line :
City : TAMPA
State : FL
Zip : 33607-1538
Country : US
Telephone Number : 407-334-0894
Fax Number :
Provider Business Practice Location Address
First Line : 515 CHESAPEAKE DR
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-2515
Country : US
Telephone Number : 727-934-4629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2017
Last Update Date : 08/10/2020

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Directions to “ JESSICA CAO ” Practice Location

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