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Individual

JARED WISHIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5200 SEMINOLE BLVD, ST PETERSBURG, FL 33708-3356
(813) 321-1786
(813) 321-1787
Mailing address
4651 VAN DYKE RD, LUTZ, FL 33558-4880
(813) 321-1786
(813) 321-1787

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
125069551
IL
207N00000X
Dermatology Physician
Primary
M144461
FL

Other

Enumeration date
03/27/2016
Last updated
07/21/2022
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