Individual
JEREMIAH JAMES PASTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3065
(863) 680-7000
(866) 264-8519
Mailing address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3065
(863) 680-7000
(866) 264-8519
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9362967
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11002694
FL
Other
Enumeration date
06/05/2019
Last updated
06/20/2019
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