Provider Demographics
NPI:1922274729
Name:SCHNEIDER, JESSICA IONE (MSPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:IONE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7770 SW 32ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3531
Mailing Address - Country:US
Mailing Address - Phone:305-261-5637
Mailing Address - Fax:
Practice Address - Street 1:12608 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1867
Practice Address - Country:US
Practice Address - Phone:305-412-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist