Healthcare Provider Details

I. General information

NPI: 1649324484
Provider Name (Legal Business Name): JASON A BUEHLER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2066 CLASSIQUE LN
TAVARES FL
32778-5787
US

IV. Provider business mailing address

2066 CLASSIQUE LN
TAVARES FL
32778-5787
US

V. Phone/Fax

Practice location:
  • Phone: 352-483-7525
  • Fax: 352-483-7529
Mailing address:
  • Phone: 352-483-7525
  • Fax: 352-483-7529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 8743
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: