Provider Demographics
NPI:1194149526
Name:CACERES, JESSICA R (DC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:R
Last Name:CACERES
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 1:2650 BAHIA VISTA ST STE 304
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2634
Mailing Address - Country:US
Mailing Address - Phone:941-777-3375
Mailing Address - Fax:
Practice Address - Street 1:2650 BAHIA VISTA ST STE 304
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2634
Practice Address - Country:US
Practice Address - Phone:941-258-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor