Provider Demographics
NPI:1083362784
Name:NEWMAN, JASON WILLIAM JR
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:WILLIAM
Last Name:NEWMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 38TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7440
Mailing Address - Country:US
Mailing Address - Phone:727-710-7147
Mailing Address - Fax:
Practice Address - Street 1:441 38TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7440
Practice Address - Country:US
Practice Address - Phone:727-710-7147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist