Individual
JASON MICHAEL MANZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
603 7TH ST S, SUITE 360, ST PETERSBURG, FL 33701-4719
(727) 553-7300
Mailing address
3814 BROCK ST, NEW PORT RICHEY, FL 34652-6106
(954) 609-9684
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS 14029
FL
Other
Enumeration date
06/07/2012
Last updated
05/27/2016
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