Provider Demographics
NPI:1144640863
Name:PEREZ, JASMINE (DC)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 FAWN RIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8268
Mailing Address - Country:US
Mailing Address - Phone:386-259-9051
Mailing Address - Fax:386-259-4243
Practice Address - Street 1:747 FAWN RIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8268
Practice Address - Country:US
Practice Address - Phone:386-259-9051
Practice Address - Fax:386-259-4243
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11137111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation