Individual
JESSE TYLER CROSNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
220 SW 84TH AVE STE 102, PLANTATION, FL 33324-2729
(954) 720-1530
(954) 620-5751
Mailing address
220 SW 84TH AVE STE 102, PLANTATION, FL 33324-2729
(954) 349-2345
(954) 349-7784
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116412
FL
363AM0700X
Medical Physician Assistant
PA9116412
FL
363AS0400X
Surgical Physician Assistant
PA9116412
FL
Other
Enumeration date
01/05/2021
Last updated
09/24/2024
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