Provider Demographics
NPI:1285640706
Name:METZ, JARED (LFO)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:METZ
Suffix:
Gender:M
Credentials:LFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-2218
Mailing Address - Country:US
Mailing Address - Phone:863-937-9200
Mailing Address - Fax:
Practice Address - Street 1:2606 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2218
Practice Address - Country:US
Practice Address - Phone:863-937-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORF259174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist