Individual
JASMINE SISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1721 BRANDON MAIN ST STE A, BRANDON, FL 33511-5018
(813) 315-1530
(813) 355-5909
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(352) 567-0188
(813) 355-5101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0110004618
VA
363AM0700X
Medical Physician Assistant
Primary
PA9110151
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022259200
—
FL
Enumeration date
06/30/2014
Last updated
01/26/2021
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