Individual provider · Type 1 NPI

Jordan Adam Conrad, PA-C

Surgical Physician Assistant · Tampa, FL

NPI number 1942557178 Active

Practice location

12880 Commodity Pl
Tampa, FL 33626-3101

Fax (866) 462-7445

Mailing address

PO Box 21686
Tampa, FL 33622-1686

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA9107357 (FL)
Surgical Physician Assistant 363AS0400X002789 (CT)

Surgical Physician Assistant: Definition to come...

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About NPI 1942557178

Jordan Adam Conrad, PA-C's National Provider Identifier is 1942557178, issued on Aug 7, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Tampa, FL. The record was last updated on Oct 10, 2013.