Provider Demographics
NPI:1134882772
Name:BELSER, JENNA LEE (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:LEE
Last Name:BELSER
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17034 KETTLE LN APT 204
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-0062
Mailing Address - Country:US
Mailing Address - Phone:850-326-0468
Mailing Address - Fax:
Practice Address - Street 1:6417 E COUNTY LINE RD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1855
Practice Address - Country:US
Practice Address - Phone:813-461-8840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist