Provider Demographics
NPI:1457322372
Name:ORLANDO, JASON K (DO)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:K
Last Name:ORLANDO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 SANDRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-9559
Mailing Address - Country:US
Mailing Address - Phone:904-272-4329
Mailing Address - Fax:904-375-8852
Practice Address - Street 1:223 BLANDING BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3357
Practice Address - Country:US
Practice Address - Phone:904-272-4329
Practice Address - Fax:904-375-8852
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381299500Medicaid
FL55925OtherBC/BS OF FLORIDA
FL381299500Medicaid
FL381299500Medicaid