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Individual

DR. JASON JEONG HWAN SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D

Contact information

Practice address
2801 17TH ST UNIT 202, SAINT CLOUD, FL 34769-4939
(407) 906-1328
(866) 425-8143
Mailing address
2801 17TH ST UNIT 202, SAINT CLOUD, FL 34769-4939
(407) 906-1328
(866) 425-8143

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
ME123792
FL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
ME123792
FL
208VP0000X
Pain Medicine Physician
Primary
123792
FL
390200000X
Student in an Organized Health Care Education/Training Program
236756
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015031800
FL
Enumeration date
02/02/2009
Last updated
10/27/2023
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