Jessica Lee Prince, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

28695 Issued in FL

Practice address

3344 Gondolier Way
Lake Worth, FL 33462-3622

Phone

(407) 687-2154

NPI assigned

Dec 21, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1508635269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 GONDOLIER WAY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334623622",
            "telephone_number": "407-687-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 GONDOLIER WAY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334623622",
            "telephone_number": "407-687-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "28695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prestige Comfort Home Health Care, LLC
• Prestige Global Nursing Services
• Primary Total Care Corp
• Prime Community Wellness Center Inc
• Primecare at Home LLC
• Jasmine Printemps
• Alison Elizabeth Prinyavivatkul, M.S., CCC-SLP
• Priority Health Transportation
• Professional Therapeutic Health Care Inc
• Proficient NP LLC

• Physical Therapy Assistant in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.