Individual
DR. JEANINE A FEDORKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2055 WOOD ST STE 120, SARASOTA, FL 34237-7928
(330) 620-1159
Mailing address
3678 PARKRIDGE CIR, SARASOTA, FL 34243-1445
(330) 620-1159
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1734
OH
111NN1001X
Nutrition Chiropractor
Primary
CH14620
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139761
ANTHEM
OH
05
—
0221638
—
OH
05
—
0857210
—
OH
01
—
1734
LICENSE
OH
01
—
20813900
US DEPT. OF LABOR-GROUP#
OH
01
—
341774514-00
WORKER'S COMP
OH
01
—
34182024800
GROUP WORKERS COMP #
OH
Enumeration date
01/24/2006
Last updated
02/16/2026
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