Individual
JASON MICHAEL LAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP-BC
Contact information
Practice address
753 16TH AVE S, ST PETERSBURG, FL 33701-5710
(603) 502-6644
Mailing address
753 16TH AVE S, ST PETERSBURG, FL 33701-5710
(603) 502-6644
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11033774
FL
Other
Enumeration date
07/11/2024
Last updated
01/20/2025
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