Individual
JARROD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 SE 17TH ST STE 119A, FORT LAUDERDALE, FL 33316-1736
(954) 859-5777
Mailing address
4300 ALTON RD, MIAMI BEACH, FL 33140-2948
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME133911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022405200
—
FL
Enumeration date
11/14/2014
Last updated
08/13/2024
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