Healthcare Provider Details

I. General information

NPI: 1003734997
Provider Name (Legal Business Name): JASON JOHN WING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 GULF BLVD
ST. PETE BEACH FL
33706
US

IV. Provider business mailing address

7301 GULF BLVD
ST PETE BEACH FL
33706-1947
US

V. Phone/Fax

Practice location:
  • Phone: 727-363-9206
  • Fax:
Mailing address:
  • Phone: 727-612-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberPMD517867
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: