Wasdin, Justin D

Wasdin, Justin D is an individual health care provider with primary practice located at 10080 Sw Innovation Way Ste 102 , Port St Lucie FL 34987-2129. 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. Wasdin, Justin D can be contacted via phone (772) 344-3811.

Contact Information

Primary practice address
10080 Sw Innovation Way Ste 102 Port St Lucie FL 34987-2129
Phone: (772) 344-3811
Fax: (772) 283-4919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9110163 Florida

Profile Details

NPI number 1245777929
LBN Legal business name Wasdin, Justin D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2017
Last updated Oct 14th, 2020 - about 6 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 1245777929 NPPES
Florida MEDICAID 019931500
Florida Other J2ZXG

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