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General NPI Number Information
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NPI Number | 1003609124
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Entity Type | Individual
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Provider Name | JALEN FRETT
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Gender | Male
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-3003
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Country | US
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Telephone | 352-265-0301
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Fax |
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Provider Business Mailing Address
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Address Line | 4515 CABBAGE PALM DR
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City | VALRICO
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State | FL
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Zip | 33596-7189
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Country | US
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Telephone | 813-527-4049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA1138
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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