Individual
JEREMY S WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMS,PA-C
Contact information
Practice address
9077 S FEDERAL HWY, PORT ST LUCIE, FL 34952-3405
(772) 335-4770
(772) 335-4133
Mailing address
9077 S FEDERAL HWY, PORT ST LUCIE, FL 34952-3405
(772) 335-4770
(772) 335-4133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104407
FL
363AM0700X
Medical Physician Assistant
PA9104407
FL
363AS0400X
Surgical Physician Assistant
PA9104407
FL
Other
Enumeration date
10/23/2007
Last updated
02/07/2020
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