JESSICA J WILSON CHAN D O PA


Address: 14522 University Point Pl, Tampa, FL 33613-5425
Phone: 8139780020

JESSICA J WILSON CHAN D O PA (NPI# 1457995953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457995953
Entity Type Organization
Organization Name JESSICA J WILSON CHAN D O PA
Practice Address 14522 University Point Pl
Tampa
FL 33613-5425
Practice Telephone 8139780020
Practice Fax Number 8139729024
Mailing Telephone 8139780020
Mailing Fax Number 8139729024
Enumeration Date 2019-10-29
Last Update Date 2019-10-29
Authorized Official Name DR. JESSICA JILL WILSON-CHAN (PHYSICIAN)
Authorized Official Telephone 8139780020
Authorized Official Credential DO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice Allopathic & Osteopathic Physicians

Office Location

Street Address 14522 UNIVERSITY POINT PL
City TAMPA
State FL
Zip Code 33613-5425

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902810963 Physical Medicine Center Clinic/Center 14522 University Point Pl, Tampa, FL 33613-5425 2006-07-27
1306153606 Jessica Jill Wilson-chan General Practice 14522 University Point Pl, Tampa, FL 33613-5425 2010-09-08
1053516245 Robert Carl Lupo Chiropractor 14522 University Point Pl, Tampa, FL 33613-5425 2007-06-18

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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1124652425 Vivant Medical Group LLC General Practice 6214 Memorial Hwy Ste B, Tampa, FL 33615-4507 2020-02-25
1003453499 Healmi Technologies, LLC General Practice 3109 W Dr Martin Luther King Jr Blvd Ste 111, Tampa, FL 33607-6237 2019-12-04
1023507407 Mildred Catherine Conneely General Practice 1701 W Jetton Ave, Tampa, FL 33606-3026 2018-05-01
1144725557 John Henry Hoenemeyer II General Practice 325 W Frierson Ave, Tampa, FL 33603-1932 2018-03-27
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1033635149 Peak Payer Solutions, Inc. General Practice 12332 Race Track Road, Tampa, FL 33626 2017-08-21
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Competitor

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City TAMPA
Zip Code 33613

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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