Individual
JAYMIE AGSALUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1771
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME102005
FL
208M00000X
Hospitalist Physician
Primary
ME102005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000589700
—
FL
01
—
ME102005
LICENSE
FL
01
—
VB718
MEDICARE HF
FL
Enumeration date
05/04/2006
Last updated
05/02/2025
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