Qualley, Jason

Qualley, Jason is an individual health care provider with primary practice located at 9981 S Healthpark Dr , Fort Myers FL 33908-3618. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Technologists, Technicians & Other Technical Service Providers / Perfusionist, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Qualley, Jason can be contacted via phone (239) 343-2052.

Contact Information

Primary practice address
9981 S Healthpark Dr Fort Myers FL 33908-3618
Phone: (239) 343-2052
Fax: (239) 343-5348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 613883 Texas
Technologists, Technicians & Other Technical Service Providers / Perfusionist 242T00000X
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X ME165604 Florida

Profile Details

NPI number 1215432901
LBN Legal business name Qualley, Jason
Credentials MD, CCP,LP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2018
Last updated May 23rd, 2024 - about last year

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 1215432901 NPPES
Florida MEDICAID 121439800

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