Most Relevant Information
Provider Data
| NPI Number: | 1003481680 |
| Provider Name: | JASIE BEHRENS PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA9114380 |
Most Important Dates
| Enumeration Date: | 05/25/2021 |
| Last Updated: | 07/19/2021 |
Provider Practice Location
1755 N FLORIDA AVE
LAKELAND
FL
338053109
Practice Location Phone/Fax
| Phone: | 8639046201 |
| Fax: | 8662648519 |
Provider Mailing Location
1600 LAKELAND HILLS BLVD
LAKELAND
FL
338053019
Provider Mailing Phone/Fax
| Phone: | 8636807000 |
| Fax: | 8662648519 |