# MR. JARED P. REISS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1558360206
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA3719 | FL | Yes |
| 363AM0700X | Medical Physician Assistant | PA3719 | FL | — |
| 363AS0400X | Surgical Physician Assistant | PA3719 | FL | — |

## Other

- **Enumeration date:** 07/15/2005
- **Last updated:** 01/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 021420100 | — | FL |