Individual provider · Type 1 NPI

Marisa Elaine Long, PA-C

Surgical Physician Assistant · Jacksonville, FL

NPI number 1346848173 Active

Practice location

836 Prudential Dr Ste 1001
Jacksonville, FL 32207-8337

Call (904) 398-0033 Map

Fax (904) 398-6774

Mailing address

11945 San Jose Blvd, Ste 300
Jacksonville, FL 32223-1627

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA9113569 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1346848173

Marisa Elaine Long, PA-C's National Provider Identifier is 1346848173, issued on Oct 14, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Jacksonville, FL. The record was last updated on Nov 25, 2020.