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JASON MARK HABECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 558-6187
Mailing address
123 HOSPITAL DR, STE 1008, WATERTOWN, WI 53098-3320
(920) 206-6500
(920) 261-4013

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301100883
MI
207X00000X
Orthopaedic Surgery Physician
Primary
ME130378
FL
390200000X
Student in an Organized Health Care Education/Training Program
4301100883
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020408900
FL
01
JA244Z
MEDICARE
FL
01
WC162
BCBS
FL
Enumeration date
05/30/2012
Last updated
06/01/2018
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