Individual
DR. JASON ANDREW BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1919 E HWY 50 STE 201, CLERMONT, FL 34711-1975
(352) 243-2622
(352) 243-6277
Mailing address
1804 OAKLEY SEAVER DR STE A, CLERMONT, FL 34711-1925
(407) 521-3600
(407) 521-3603
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME92559
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03417
BCBS PROVIDER NUMBER
FL
01
—
1174745962
NPI
—
05
—
279419500
—
FL
01
—
7460692
AETNA PROVIDER NUMBER
FL
Enumeration date
05/03/2007
Last updated
03/13/2024
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