Provider Demographics
NPI:1619914157
Name:PINSON, JAZMYN KAREN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JAZMYN
Middle Name:KAREN
Last Name:PINSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:JAZMYN
Other - Middle Name:KAREN
Other - Last Name:PINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:LAKE TOXAWAY
Mailing Address - State:NC
Mailing Address - Zip Code:28747-0156
Mailing Address - Country:US
Mailing Address - Phone:941-724-1453
Mailing Address - Fax:866-620-4117
Practice Address - Street 1:1906 GLENGARY ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3606
Practice Address - Country:US
Practice Address - Phone:941-925-3557
Practice Address - Fax:941-925-3557
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA23169225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC8574OtherBLUE CROSS BLUE SHIELD