JARED DEVIRGILIS

BRADENTON, FL
NPI1548719065
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: FL  PA 9109796)
Enumeration Date2016-09-26
Last Update Date2019-05-21
Business Address
JARED DEVIRGILIS PA-C
206 2ND ST E
BRADENTON, FL 34208-1042
Phone number: 941-746-5111
Mailing Address
JARED DEVIRGILIS PA-C
367 S. GULPH RD ATTN: IPM CREDENTIALING
KING OF PRUSSIA, PA 19406-3121
Phone number: 941-746-5111