Individual
JORDAN LANE LASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 875-0555
Mailing address
2259 BANCROFT BLVD, ORLANDO, FL 32833-3804
(561) 512-6749
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118385
FL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/15/2024
Last updated
04/16/2024
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