Walters, Jason Anthony

Walters, Jason Anthony is an individual health care provider with primary practice located at 1601 S Andrews Ave Fl 2 , Fort Lauderdale FL 33316-2509. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Walters, Jason Anthony can be contacted via phone (954) 522-3355.

Contact Information

Primary practice address
1601 S Andrews Ave Fl 2 Fort Lauderdale FL 33316-2509
Phone: (954) 522-3355
Fax: (954) 522-9590
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X P7722 Texas
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X ME117228 Florida

Profile Details

NPI number 1063679553
LBN Legal business name Walters, Jason Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2008
Last updated Apr 4th, 2024 - about 8 months 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 1063679553 NPPES
Florida MEDICAID 018508700

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