Provider Demographics
NPI:1073501540
Name:JARRETT, JERE N (DC)
Entity Type:Individual
Prefix:DR
First Name:JERE
Middle Name:N
Last Name:JARRETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N GARDEN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4124
Mailing Address - Country:US
Mailing Address - Phone:727-447-4647
Mailing Address - Fax:727-443-3195
Practice Address - Street 1:205 N GARDEN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4124
Practice Address - Country:US
Practice Address - Phone:727-447-4647
Practice Address - Fax:727-443-3195
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22344ZMedicare UPIN
FLT37582Medicare UPIN