Provider Demographics
NPI:1013432855
Name:PERRY, JAZMIN ANISSA (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:ANISSA
Last Name:PERRY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 W SPRUCE ST APT 307
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4209
Mailing Address - Country:US
Mailing Address - Phone:614-537-7350
Mailing Address - Fax:
Practice Address - Street 1:4809 N ARMENIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1436
Practice Address - Country:US
Practice Address - Phone:813-877-1930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-12
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist