Individual
JAROSLAVA S TEET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 649-6907
(407) 481-2035
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 649-6907
(407) 481-2035
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
00000PA16743
CA
363AS0400X
Surgical Physician Assistant
Primary
PA9105962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004957100
—
FL
01
—
PA9105962
MEDICAL LICENSE
FL
Enumeration date
10/19/2006
Last updated
07/02/2019
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