Individual
JEFFREY MASSARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1211 E KENNEDY BLVD UNIT 530, TAMPA, FL 33602-3783
(718) 759-6100
Mailing address
1211 E KENNEDY BLVD UNIT 530, TAMPA, FL 33602-3783
(718) 759-6100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024681
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9113916
FL LICENSE
FL
Enumeration date
02/11/2020
Last updated
10/25/2023
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