MEDICARE: MR. JASON M ZITER PA-C

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	363A00000X	Physician Assistant	5129	SC
2	363AM0700X	Medical Physician Assistant	PA9103100	FL
3	363AM0700X	Medical Physician Assistant	5601004445	MI
4	363AS0400X	Surgical Physician Assistant	L5597278	MI
5	363AS0400X	Surgical Physician Assistant	PA 9103100	FL
6	363A00000X	Physician Assistant	PA9103100	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
2	Y04CU	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891790085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON M ZITER PA-C

Provider Business Mailing Address
First Line	:	PO BOX 26067
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84126-0067
Country	:	US
Telephone Number	:	239-624-0400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1285 CREEKSIDE BLVD E UNIT 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-0595
Country	:	US
Telephone Number	:	239-624-0310
Fax Number	:	239-624-0311

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/31/2024

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Directions to “ MR. JASON M ZITER PA-C” Practice Location

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