Individual
MR. FREDERICK JASON MCNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
922 E CALL ST, STARKE, FL 32091-3616
(904) 368-2300
(904) 368-2306
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102191
FL
363AS0400X
Surgical Physician Assistant
PA9102191
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291787400
—
FL
Enumeration date
04/12/2006
Last updated
05/14/2019
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