Hagerty, Jason R

Hagerty, Jason R is an sole proprietor health care provider with primary practice located at 1120 10Th St E , Palmetto FL 34221-4134. He recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Urgent Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Hagerty, Jason R can be contacted via phone (941) 847-7903.

Contact Information

Primary practice address
1120 10Th St E Palmetto FL 34221-4134
Phone: (941) 847-7903
Fax: (941) 847-7919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Urgent Care 261QU0200X COA.16064-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA.16064-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9396930 Florida

Profile Details

NPI number 1073928537
LBN Legal business name Hagerty, Jason R
Credentials NP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 24th, 2014
Last updated Nov 4th, 2021 - about 3 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 1073928537 NPPES
Florida MEDICAID 014664800

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