Individual
DR. JARED JOHN WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
938 OAKFIELD DR, BRANDON, FL 33511-4950
(813) 278-8850
(813) 820-3508
Mailing address
938 OAKFIELD DR, BRANDON, FL 33511-4950
(813) 278-8850
(813) 820-3508
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME131777
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120075300
—
FL
Enumeration date
03/27/2012
Last updated
10/30/2023
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