Provider Demographics
NPI:1073184230
Name:WEBER, JESSLYN LEE (PA-C)
Entity type:Individual
Prefix:MS
First Name:JESSLYN
Middle Name:LEE
Last Name:WEBER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:400 PINELLAS ST STE 325
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3320
Practice Address - Country:US
Practice Address - Phone:727-298-6121
Practice Address - Fax:727-533-5903
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026743012084N0400X
NY026743363A00000X
FLPA9117808363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology