Provider Demographics
NPI:1285175026
Name:BIGGS, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 530242
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33747-0242
Mailing Address - Country:US
Mailing Address - Phone:727-512-3425
Mailing Address - Fax:
Practice Address - Street 1:4222 22ND AVE S
Practice Address - Street 2:530242
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33747-8128
Practice Address - Country:US
Practice Address - Phone:727-512-3425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCL12582241744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management