Individual
JONATHAN THOMAS NUSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-4896
(941) 917-6884
Mailing address
200 N LAKEMONT AVE, WINTER PARK, FL 32792-3273
(407) 303-7283
(407) 303-0347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113497
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109137800
—
FL
Enumeration date
10/28/2020
Last updated
02/10/2026
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