Individual
JASHIRA RUPERTO-SWALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2020 59TH ST W, BRADENTON, FL 34209-4604
(941) 792-6611
Mailing address
2020 59TH ST W, BRADENTON, FL 34209-4604
(941) 792-6611
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9109468
FL
363AS0400X
Surgical Physician Assistant
9109468
FL
Other
Enumeration date
11/11/2016
Last updated
11/11/2016
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