Individual
MR. JASON L LOCKRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1761 PALM BAY RD NE, PALM BAY, FL 32905-2902
(321) 220-6400
(321) 220-6401
Mailing address
900 VILLAGE SQUARE XING STE 290, PALM BEACH GARDENS, FL 33410-4552
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME140072
FL
Other
Enumeration date
09/08/2005
Last updated
05/17/2022
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