Individual
JAKKI BOSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3910 NORTHDALE BLVD, SUITE 208, TAMPA, FL 33624-1800
(813) 298-5603
Mailing address
1710 ESCORT AVE, TAMPA, FL 33610-3451
(813) 298-5603
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA45584
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4124
BCBSF PROVIDER NUMBER
FL
Enumeration date
01/03/2007
Last updated
07/08/2007
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