Provider Demographics
NPI:1679554307
Name:MAYSONET, JOSE ORLANDO (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ORLANDO
Last Name:MAYSONET
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:6419 BRIDGECREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547
Mailing Address - Country:US
Mailing Address - Phone:813-685-7554
Mailing Address - Fax:
Practice Address - Street 1:8415 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:MACDILL AFB
Practice Address - State:FL
Practice Address - Zip Code:33621-1607
Practice Address - Country:US
Practice Address - Phone:813-827-9229
Practice Address - Fax:813-827-9264
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical