Individual
JASON STANLEY FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 PALM COAST PKWY SE, PALM COAST, FL 32137-8209
(872) 231-3162
Mailing address
PO BOX 22239, SUITE 100, NEW YORK, NY 10087-0001
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME164903
FL
Other
Enumeration date
06/26/2013
Last updated
11/25/2025
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