Dumrongkulraksa, Jason Tyler

Dumrongkulraksa, Jason Tyler is an sole proprietor health care provider with primary practice located at 615 N Bonita Ave , Panama City FL 32401-3623. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dumrongkulraksa, Jason Tyler can be contacted via phone (850) 747-6000.

Contact Information

Primary practice address
615 N Bonita Ave Panama City FL 32401-3623
Phone: (850) 747-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9106023 Florida

Profile Details

NPI number 1205115573
LBN Legal business name Dumrongkulraksa, Jason Tyler
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2011
Last updated Dec 16th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205115573 NPPES
Florida Other PA9106023 FLORIDA BOARD OF MEDICINE

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