Individual
JASON DESCALSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
380 CELEBRATION PL FL 3, CELEBRATION, FL 34747-4606
(407) 303-4673
Mailing address
380 CELEBRATION PL FL 3, CELEBRATION, FL 34747-4606
(407) 303-4673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104051
FL
363AS0400X
Surgical Physician Assistant
PA9104051
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292716100
—
FL
01
—
HF826A
GRP PTAN QSS-SCS
FL
Enumeration date
12/19/2006
Last updated
08/30/2023
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