Individual
DR. AMMAR JESRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4211 VAN DYKE RD, SUITE 200, LUTZ, FL 33558-8005
(813) 321-6237
(813) 463-1801
Mailing address
4211 VAN DYKE RD STE 200, LUTZ, FL 33558-8005
(813) 321-6237
(813) 463-1801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME114199
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090754-00
—
FL
01
—
P01478204
RAILROAD MEDICARE PROVIDER NUMBER
FL
Enumeration date
11/07/2006
Last updated
04/04/2022
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