Individual
MR. JASON LEE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
5113 NEPONSET AVE, ORLANDO, FL 32808-1655
(863) 307-6750
Mailing address
5113 NEPONSET AVE, ORLANDO, FL 32808-1655
(863) 307-6750
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11002440
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235696915
PROVIDER
FL
Enumeration date
02/28/2019
Last updated
10/02/2023
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