Provider Demographics
NPI:1225357031
Name:BRIONES, JAZMINE (MA)
Entity Type:Individual
Prefix:
First Name:JAZMINE
Middle Name:
Last Name:BRIONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 W WATERS AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2716
Mailing Address - Country:US
Mailing Address - Phone:813-374-0298
Mailing Address - Fax:813-374-2224
Practice Address - Street 1:3550 W WATERS AVE STE 260
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2716
Practice Address - Country:US
Practice Address - Phone:813-374-0298
Practice Address - Fax:813-374-2224
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49559225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist