Individual
MS. JESSICA ELIZABETH BANGORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 487-5400
(941) 487-5430
Mailing address
1313 LAUREL AVE, VENICE, FL 34285-7924
(941) 248-5068
(941) 487-5430
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
768288300
—
FL
Enumeration date
02/28/2007
Last updated
12/27/2022
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