Provider Demographics
NPI:1760754170
Name:CIROLIA, JASON TYLER (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:TYLER
Last Name:CIROLIA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13730 MIRROR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7422
Mailing Address - Country:US
Mailing Address - Phone:386-589-5289
Mailing Address - Fax:
Practice Address - Street 1:831 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5328
Practice Address - Country:US
Practice Address - Phone:407-483-5757
Practice Address - Fax:407-350-5291
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL265362251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic