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Individual

JEAN L TOLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6550 N FEDERAL HWY, SUITE 512, FORT LAUDERDALE, FL 33308-1404
(954) 267-8777
(954) 772-7801
Mailing address
6550 N FEDERAL HWY, SUITE 512, FORT LAUDERDALE, FL 33308-1404
(954) 267-8777
(954) 772-7801

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0002563
FL
363AS0400X
Surgical Physician Assistant
Primary
PA 2563
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E0983V
MEDICARE PTAN
FL
01
P00450777
MEDICARE RAIL ROAD
FL
Enumeration date
09/12/2006
Last updated
05/05/2010
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