Provider Demographics
NPI:1114788288
Name:JASPER HEALTH SERVICES FLORIDA LLC
Entity type:Organization
Organization Name:JASPER HEALTH SERVICES FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ORR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-419-5668
Mailing Address - Street 1:235 N WESTMONTE DR
Mailing Address - Street 2:1ST AND 2ND FLOOR
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3345
Mailing Address - Country:US
Mailing Address - Phone:929-552-3904
Mailing Address - Fax:
Practice Address - Street 1:235 N WESTMONTE DR
Practice Address - Street 2:1ST AND 2ND FLOOR
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3345
Practice Address - Country:US
Practice Address - Phone:929-552-3904
Practice Address - Fax:877-254-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty