Wazen, Jack J

Wazen, Jack J is an individual health care provider with primary practice located at 1901 Floyd St , Sarasota FL 34239-2932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otology & Neurotology, which is considered as his primary health care specialty. Wazen, Jack J can be contacted via phone (941) 366-9222.

Contact Information

Primary practice address
1901 Floyd St Sarasota FL 34239-2932
Phone: (941) 366-9222
Fax: (941) 365-2269
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otology & Neurotology 207YX0901X ME41616 Florida

Profile Details

NPI number 1801806757
LBN Legal business name Wazen, Jack J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Dec 2nd, 2020 - about 5 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 1801806757 NPPES
Florida MEDICAID 274489900
Florida Other 31040

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