Healthcare Provider Details

I. General information

NPI: 1851529945
Provider Name (Legal Business Name): JASON DEGREGORIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEADOWS RD
BOCA RATON FL
33486-2304
US

IV. Provider business mailing address

PO BOX 198227
ATLANTA GA
30384-8227
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-4730
  • Fax:
Mailing address:
  • Phone: 561-955-4720
  • Fax: 561-955-2127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberME110011
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME110011
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME110011
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberLP00282
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: