Individual
MR. JASON JOSEPH MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
256 SW PROFESSIONAL GLN, LAKE CITY, FL 32025-1104
(386) 758-8937
(386) 755-2169
Mailing address
PO BOX 550902, SUNBELT ANESTHESIA SERVICES, JACKSONVILLE, FL 32255-0902
(904) 502-2502
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9172755
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3074935-00
—
FL
05
—
552391106A
—
GA
01
—
G3954
BCBS
FL
01
—
P00326148
RAILROAD MEDICARE
FL
Enumeration date
04/04/2006
Last updated
07/28/2016
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