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1548719065
JARED DEVIRGILIS
BRADENTON, FL
NPI
1548719065
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: FL PA 9109796)
Enumeration Date
2016-09-26
Last Update Date
2019-05-21
Business Address
JARED DEVIRGILIS PA-C
206 2ND ST E
BRADENTON, FL 34208-1042
Phone number: 941-746-5111
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Mailing Address
JARED DEVIRGILIS PA-C
367 S. GULPH RD ATTN: IPM CREDENTIALING
KING OF PRUSSIA, PA 19406-3121
Phone number: 941-746-5111
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