Provider Demographics
NPI:1174849087
Name:SUMINSKI, JESSI N (BC-HIS)
Entity Type:Individual
Prefix:
First Name:JESSI
Middle Name:N
Last Name:SUMINSKI
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 SAN JOSE BLVD W
Mailing Address - Street 2:6014 SAN JOSE BLVD
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2365
Mailing Address - Country:US
Mailing Address - Phone:904-425-4393
Mailing Address - Fax:904-425-4394
Practice Address - Street 1:6014 SAN JOSE BLVD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2365
Practice Address - Country:US
Practice Address - Phone:904-425-4393
Practice Address - Fax:904-425-4394
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4183237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist