Doctor Name: | JASON R HAGERTY |
NPI Number: | 1073928537 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP-C |
License Number: | COA.16064-NP |
Business Practice Address: | 3771 Tampa Rd Oldsmar, FL - 346773004 |
Business Phone Number: | 8138555781 |
Business Fax Number: | |
Mailing Address: | 3771 Tampa Rd, OLDSMAR |
State: | FL |
Postal Code: | 346773004 |
Phone Number: | 8138555781 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2014 |
NPI Last Update Date: | 04/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | COA.16064-NP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |