JORDAN RYAN LASTRA

TAMPA, FL
NPI1598481574
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: FL  11022374)
Enumeration Date2022-10-12
Last Update Date2023-01-03
Business Address
JORDAN RYAN LASTRA APRN
2605 W SWANN AVE STE 600
TAMPA, FL 33609-4044
Phone number: 813-876-7073
Mailing Address
JORDAN RYAN LASTRA APRN
2605 W SWANN AVE STE 600
TAMPA, FL 33609-4044
Phone number: 813-876-7073
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