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General NPI Number Information
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NPI Number | 1508669235
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Entity Type | Individual
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Provider Name | JASON JEVANTE PHILSON DHA
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Gender | Male
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 7207 & 7225 N NEBRASKA AVE
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City | TAMPA
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State | FL
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Zip | 33604
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Country | US
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Telephone | 904-900-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 1918 E SHADOWLAWN AVE
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City | TAMPA
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State | FL
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Zip | 33610-5042
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Country | US
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Telephone | 757-274-8766
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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