MEDICARE: JESSICA STARRETT

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
1	225100000X	Physical Therapist	PT25847	FL

General Provider Information

NPI Number	:	1972867588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA STARRETT

Provider Business Mailing Address
First Line	:	13300 ATLANTIC BLVD
Second Line	:	APT 1208
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-6136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13300 ATLANTIC BLVD
Second Line	:	APT 1208
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-6136
Country	:	US
Telephone Number	:	832-545-5377
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2012
Last Update Date	:	06/28/2012

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Directions to “ JESSICA STARRETT ” Practice Location

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