Individual
JAIRO ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1137 LANCER LN, TARPON SPRINGS, FL 34689-8034
(727) 657-5194
Mailing address
1137 LANCER LN, TARPON SPRINGS, FL 34689-8034
(727) 657-5194
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PTA22596
FL
Other
Enumeration date
12/06/2014
Last updated
12/06/2014
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