Healthcare Provider Details

I. General information

NPI: 1811344005
Provider Name (Legal Business Name): JO ANNA KOHLER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 BELFORT RD STE 4030
JACKSONVILLE FL
32216-1475
US

IV. Provider business mailing address

2625 HARLEM RD STE 240
CHEEKTOWAGA NY
14225-4031
US

V. Phone/Fax

Practice location:
  • Phone: 904-450-6090
  • Fax:
Mailing address:
  • Phone: 716-893-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9120465
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: