Provider Demographics
NPI:1922580083
Name:JALBERT-CAPUTO, VANESSA MICHELLE (DC)
Entity Type:Individual
Prefix:MISS
First Name:VANESSA
Middle Name:MICHELLE
Last Name:JALBERT-CAPUTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 MADACA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2057
Mailing Address - Country:US
Mailing Address - Phone:813-217-3539
Mailing Address - Fax:813-961-5040
Practice Address - Street 1:3602 MADACA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2057
Practice Address - Country:US
Practice Address - Phone:813-217-3539
Practice Address - Fax:813-961-5040
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor