Individual
MR. JASON MARKOS MALLIS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5147 N 9TH AVE STE 103, PENSACOLA, FL 32504-8770
(850) 416-1900
(850) 416-1958
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6063
(904) 539-4091
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118897
FL
Other
Enumeration date
07/26/2021
Last updated
10/03/2024
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