| Doctor Name: | JARED A DESTACKELBERG |
| NPI Number: | 1104136399 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PAT 9105672 |
| Business Practice Address: | 1901 Se 18th Ave Ste 101 Ocala, FL - 344718215 |
| Business Phone Number: | 3526223360 |
| Business Fax Number: | 3526713269 |
| Mailing Address: | 1901 Se 18th Ave, Ste 101 OCALA |
| State: | FL |
| Postal Code: | 344718215 |
| Phone Number: | 3526223360 |
| Fax Number: | 3526713269 |
| NPI Enumeration Date: | 10/21/2010 |
| NPI Last Update Date: | 10/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363A00000X |
| License Number: | PAT 9105672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |