Individual
JESSE L KRESAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, STE 3109, GAINESVILLE, FL 32610-3003
(352) 265-0238
Mailing address
1600 SW ARCHER RD, PO BOX 100275, GAINESVILLE, FL 32610-3003
(352) 265-0238
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
ME 118055
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12296200
—
FL
Enumeration date
05/12/2010
Last updated
09/03/2014
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