| Miss Kim M Jaqua, DC | |
|
6449 38th Ave N, Suite B3, St Petersburg, FL 33710-1655 | |
| (727) 347-2225 | |
| Not Available |
| Full Name | Miss Kim M Jaqua |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 6449 38th Ave N, St Petersburg, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659533305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH9579 (Florida) | Primary |
| Provider Name | Parker University |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669582680 PECOS PAC ID: 7810945466 Enrollment ID: O20050110001086 |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Kim M Jaqua, DC 6449 38th Ave N, Suite B3, St Petersburg, FL 33710-1655 Ph: (727) 347-2225 | Miss Kim M Jaqua, DC 6449 38th Ave N, Suite B3, St Petersburg, FL 33710-1655 Ph: (727) 347-2225 |
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