Provider Demographics
NPI:1003907577
Name:JASIONOWSKI, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:JASIONOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 NOKOMIS AVE S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2418
Mailing Address - Country:US
Mailing Address - Phone:941-484-9718
Mailing Address - Fax:941-485-6314
Practice Address - Street 1:329 NOKOMIS AVE S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2418
Practice Address - Country:US
Practice Address - Phone:941-484-9718
Practice Address - Fax:941-485-6314
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040086207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
592326366OtherPPO
592326366OtherHMO
FS0988160OtherTRICARE
58376OtherBLUE CROSS/SHIELD
592326366OtherCOMMERCIAL
FLD21792Medicare UPIN
58376OtherBLUE CROSS/SHIELD