Provider Demographics
NPI:1194899328
Name:CASERTA JACHIMEK, GAIL ANNA (DC)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ANNA
Last Name:CASERTA JACHIMEK
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 1:5111 EHRLICH ROAD
Mailing Address - Street 2:SUITE 128
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624
Mailing Address - Country:US
Mailing Address - Phone:813-960-2225
Mailing Address - Fax:813-968-1784
Practice Address - Street 1:5111 EHRLICH ROAD
Practice Address - Street 2:SUITE 128
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624
Practice Address - Country:US
Practice Address - Phone:813-960-2225
Practice Address - Fax:813-968-1784
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor