Individual
JASON SIREL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
525 N DACIE PT, LECANTO, FL 34461-8399
(352) 746-2200
(352) 746-9320
Mailing address
4651 VAN DYKE RD, LUTZ, FL 33558-4880
(813) 321-1786
(813) 321-1787
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11022181
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115973000
—
FL
Enumeration date
10/12/2022
Last updated
11/12/2022
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