Coleman, Jessidra
Coleman, Jessidra is an sole proprietor health care provider with primary practice located at 17615 Sw 97Th Ave , Palmetto Bay FL 33157-5636. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Coleman, Jessidra can be contacted via phone (786) 268-2611.Contact Information
Primary practice address
17615 Sw 97Th Ave
Palmetto Bay FL 33157-5636
Phone: (786) 268-2611
Fax: (786) 252-2421
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1750513420 |
|---|---|
| LBN Legal business name | Coleman, Jessidra |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2009 |
| Last updated | Aug 14th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750513420 | NPPES |
| Florida | MEDICAID | 762132900 |
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