Provider Demographics
NPI:1275883704
Name:DELLORSO, JESSICA ZAROU (MPH, MMS, PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ZAROU
Last Name:DELLORSO
Suffix:
Gender:F
Credentials:MPH, MMS, PA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:T
Other - Last Name:ZAROU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, MMS, PA-C
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:1660 PRUDENTIAL DR STE 400
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8188
Practice Address - Country:US
Practice Address - Phone:904-396-0000
Practice Address - Fax:904-390-7500
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110017363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant