Jason Jeremy Weber, PTA

Individual provider Active NPI Physical Therapy Assistant · Kenneth City, FL

NPI 1992079792 · NPPES record last updated Feb 27, 2012

Key facts

NPI
1992079792
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA20342 (FL)
Practice address
4250 66TH St N
Kenneth City, FL 33709-4918
Phone
(727) 546-2405
NPI assigned
Feb 27, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA20342FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA20342 FL Yes

Addresses

Primary practice location

4250 66TH St N
Kenneth City, FL 33709-4918

Mailing address

337 37TH St S
St Petersburg, FL 33711-1601
Phone (727) 518-4757

Other providers in Kenneth City, FL

All providers in Kenneth City, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.