Provider Demographics
NPI:1699282004
Name:DOPICO, JENNY GARCIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:GARCIA
Last Name:DOPICO
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 PRATT BLVD
Mailing Address - Street 2:
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-4405
Mailing Address - Country:US
Mailing Address - Phone:863-674-4041
Mailing Address - Fax:
Practice Address - Street 1:1140 PRATT BLVD
Practice Address - Street 2:
Practice Address - City:LABELLE
Practice Address - State:FL
Practice Address - Zip Code:33935-4405
Practice Address - Country:US
Practice Address - Phone:863-674-4041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily