Provider Demographics
NPI:1609593342
Name:ASSEESSI, JENNY MARIA
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:MARIA
Last Name:ASSEESSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11115 MARTIN LUTHER KING BLVD E
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-8378
Mailing Address - Country:US
Mailing Address - Phone:813-689-4049
Mailing Address - Fax:
Practice Address - Street 1:11115 MARTIN LUTHER KING BLVD E
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-8378
Practice Address - Country:US
Practice Address - Phone:813-689-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist