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NPI Code Detail

MEDICARE: JESSICA WHEELEY MCCARRY PA-C

MEDICARE: JESSICA WHEELEY MCCARRY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA9109022FL
2363A00000XPhysician AssistantPA9109022FL

General Provider Information

NPI Number : 1124497334
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA WHEELEY MCCARRY PA-C
Provider Business Mailing Address
First Line : 502 S FREMONT AVE
Second Line : APT 818
City : TAMPA
State : FL
Zip : 33606-2068
Country : US
Telephone Number : 727-410-9830
Fax Number :
Provider Business Practice Location Address
First Line : 1515 22ND AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33704-3113
Country : US
Telephone Number : 727-895-1515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2015
Last Update Date : 08/25/2016

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Directions to “ JESSICA WHEELEY MCCARRY PA-C” Practice Location

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