Individual
MRS. JENNIFER ANN WASYLYNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1752 WALCOTT ST, WESLEY CHAPEL, FL 33543-4070
(813) 312-2928
Mailing address
1752 WALCOTT ST, WESLEY CHAPEL, FL 33543-4070
(813) 312-2928
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA37193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4120
BLUE CROSS BLUE SHEILD
FL
Enumeration date
12/08/2006
Last updated
10/29/2012
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