Provider Demographics
NPI:1114254422
Name:CARTWRIGHT, JASMINE ROSE (LAC)
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:ROSE
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5058 HIDDEN PATH WAY APT 202
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7482
Mailing Address - Country:US
Mailing Address - Phone:407-276-3963
Mailing Address - Fax:
Practice Address - Street 1:2500 WEST LAKE MARY BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3501
Practice Address - Country:US
Practice Address - Phone:407-936-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2608171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist