Jacob Lee Wonderlich in Davenport - Physician Assistant
Jacob Lee Wonderlich - NPI 1255446878
Jacob Lee Wonderlich is a Physician Assistant in Davenport, Florida. Jacob Lee Wonderlich practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jacob Lee Wonderlich is 1255446878. The last update date is 2021-07-07.
Jacob Lee Wonderlich's current location address is 40100 Highway 27, Davenport, Florida. You can contact this provider via phone number 8634224971. The mailing address for Jacob Lee Wonderlich is 40100 Highway 27, Davenport, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jacob Lee Wonderlich |
|---|---|
| Address | 40100 Highway 27, Davenport, Florida |
| Phone Number | 8634224971 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1255446878 |
|---|---|
| Provider Enumeration Date | 2006-08-21 |
| Last Updated Date | 2021-07-07 |
Provider Mailing Address Detail
| Address | 40100 Highway 27 |
|---|---|
| City | Davenport |
| State | Florida (FL) |
| Post Code | 33837 |
| Phone Number | 8634224971 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA9103414 |
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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 perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 292248700 | FL | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jacob Lee Wonderlich by the Centers for Medicare & Medicaid Services?
The Jacob Lee Wonderlich has been issued the NPI (National Provider Identifier) 1255446878, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jacob Lee Wonderlich?
The Jacob Lee Wonderlich is situated at 40100 Highway 27, in the city of Davenport, state of FL, with the zip code 33837.
What is the Jacob Lee Wonderlich's specialty and taxonomy code?
The Jacob Lee Wonderlich's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did the Jacob Lee Wonderlich receive the assignment of its 1255446878 from the Centers for Medicare & Medicaid Services?
The Jacob Lee Wonderlich was issued its 1255446878 by the Centers for Medicare & Medicaid Services on 2006-08-21.
As of what date was the information pertaining to Jacob Lee Wonderlich, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jacob Lee Wonderlich, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2021-07-07.
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