Individual provider · Type 1 NPI

Jared A. Destackelberg, PA

Physician Assistant · Ocala, FL

NPI number 1104136399 Active

Practice location

1901 SE 18th Ave, Ste 101
Ocala, FL 34471-8215

Call (352) 622-3360 Map

Fax (352) 671-3269

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPAT 9105672 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104136399

Jared A. Destackelberg, PA's National Provider Identifier is 1104136399, issued on Oct 21, 2010. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Ocala, FL. The record was last updated on Oct 21, 2010.