Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD024651E | PA |
N | 208600000X | Surgeon | MD024651E | PA |
Y | 208200000X | Surgeon | ME124619 | FL |
Y | 208600000X | Surgeon | ME124619 | FL |
N | 2086S0129X | Vascular Surgeon | MD024651E | PA |
NPI | 1164422325 |
---|---|
Provider Name | Fredric Jarrett |
First Address | Sarasota, FL 34236-7102 |
Second Address | Sarasota, FL 34236-7118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 10/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007833600004 | (05) | PA |
441231048 | RAILROAD MEDICARE (01) | PA |
E55520 | (02) | PA |