Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2006022623 | MO |
Y | 207X00000X | Orthopaedic Surgeon | OS14041 | FL |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 2006022623 | MO |
NPI | 1013000769 |
---|---|
Provider Name | Jason M Mlnarik |
First Address | Port Charlotte, FL 33948-1018 |
Second Address | Port Charlotte, FL 33948-1018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 10/01/2017 |