Mora, Jessica
Mora, Jessica is an sole proprietor health care provider with primary practice located at 5237 Sw 40Th Ave , Fort Lauderdale FL 33314-6501. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Mora, Jessica can be contacted via phone (305) 298-7966.Contact Information
Primary practice address
5237 Sw 40Th Ave
Fort Lauderdale FL 33314-6501
Phone: (305) 298-7966
Fax: (954) 584-8190
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | AL1012 | Florida |
Profile Details
| NPI number | 1417005646 |
|---|---|
| LBN Legal business name | Mora, Jessica |
| Credentials | ATC, CSCS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1417005646 | NPPES |
| Florida | Other | AL1012 | ATHLETIC TRAINER |
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