MEDICARE: JASON M JEWELL, DC, PA

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
1	111N00000X	Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649818345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASON M JEWELL, DC, PA

Provider Business Mailing Address
First Line	:	123 DATE PALM DR
Second Line	:
City	:	LAKE PARK
State	:	FL
Zip	:	33403-3571
Country	:	US
Telephone Number	:	561-900-4327
Fax Number	:	772-905-2550

Provider Business Practice Location Address
First Line	:	4223 NORTHLAKE BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6251
Country	:	US
Telephone Number	:	561-900-4327
Fax Number	:	772-905-2550

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JASON M JEWELL
Credential	:	DC
Telephone Number	:	561-900-4327

Provider Enumeration Date	:	12/13/2019
Last Update Date	:	12/13/2019

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