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1366076945
ETHAN JACOB WAJSWOL
JACKSONVILLE, FL
NPI
1366076945
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208800000X Urology
(Licence: FL ME153288)
Enumeration Date
2020-02-24
Last Update Date
2022-01-11
Business Address
Mr. ETHAN JACOB WAJSWOL MD (5/18/2020)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224-1865
Phone number: 904-953-2000
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Mailing Address
Mr. ETHAN JACOB WAJSWOL MD (5/18/2020)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224-1865
Phone number: 904-953-2000
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