Healthcare Provider Details

I. General information

NPI: 1144061961
Provider Name (Legal Business Name): JARRON FEVRIER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7544 JACQUE RD
HUDSON FL
34667-7162
US

IV. Provider business mailing address

9590 CORONA ST
MIRAMAR FL
33025-4262
US

V. Phone/Fax

Practice location:
  • Phone: 954-701-7285
  • Fax:
Mailing address:
  • Phone: 954-701-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9119172
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: