Individual
MS. JERRAH MARIA MOSTKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5 TAMPA GENERAL CIR, HMT SUITE 820, TAMPA, FL 33606-3658
(813) 844-3228
(813) 844-7730
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9114907
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113811500
—
FL
01
—
O0REO
BCBS
FL
Enumeration date
06/29/2018
Last updated
06/27/2024
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