MEDICARE: JASON B CARTER 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
1	363AM0700X	Medical Physician Assistant	PA 9102211	FL

General Provider Information

NPI Number	:	1487654406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON B CARTER PA

Provider Business Mailing Address
First Line	:	70 W GORE ST
Second Line	:	STE 202
City	:	ORLANDO
State	:	FL
Zip	:	32806-1124
Country	:	US
Telephone Number	:	407-244-8559
Fax Number	:	407-244-8560

Provider Business Practice Location Address
First Line	:	70 W GORE ST
Second Line	:	STE 202
City	:	ORLANDO
State	:	FL
Zip	:	32806-1124
Country	:	US
Telephone Number	:	407-244-8559
Fax Number	:	407-244-8560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	11/08/2010

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Directions to “ JASON B CARTER PA” Practice Location

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