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NPI Code Detail

MEDICARE: JASON NAGEL PA

MEDICARE: JASON NAGEL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPAT9103432FL

General Provider Information

NPI Number : 1194775882
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON NAGEL PA
Provider Business Mailing Address
First Line : PO BOX 552205
Second Line :
City : TAMPA
State : FL
Zip : 33655-0001
Country : US
Telephone Number : 800-476-8646
Fax Number : 919-382-3210
Provider Business Practice Location Address
First Line : 250 N WICKHAM RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-8625
Country : US
Telephone Number : 800-476-8646
Fax Number : 919-382-3210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 07/08/2007

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Directions to “ JASON NAGEL PA” Practice Location

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