MEDICARE: DR. JASON FROST D.O.

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	208600000X	Surgery Physician	OS5557	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821022989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON FROST D.O.

Provider Business Mailing Address
First Line	:	601 N FLAMINGO RD STE 319
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-1011
Country	:	US
Telephone Number	:	954-442-8786
Fax Number	:	954-442-3767

Provider Business Practice Location Address
First Line	:	601 N FLAMINGO RD STE 319
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-1011
Country	:	US
Telephone Number	:	954-442-8786
Fax Number	:	954-442-3767

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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