IndividualActive
Gina Jackson, PTA
NPI 1619658192 · Physical Therapy Assistant · Lakeland, FL
Provider details
- NPI number
- 1619658192
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- Yes
- License
- PTA27269 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
716 E Bella Vista St
Lakeland, FL 33805-3009
Phone: (863) 683-6504
Street-level locationGet directions
Mailing address
716 E Bella Vista St
Lakeland, FL 33805-3009
Additional practice locations (2)
- 695 E Summerlin StBartow, FL 33830-4848Phone: (863) 255-8307
- 2211 28th St NwWinter Haven, FL 33881-1807Phone: (863) 683-6504
Registry dates
- Enumerated
- 2023-07-27
- Last updated
- 2023-07-27
- Certified
- 2023-07-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.