Provider Demographics
NPI:1366561300
Name:COOPER, JASON SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:SCOTT
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3535 MILITARY TRL
Mailing Address - Street 2:#204
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5009
Mailing Address - Country:US
Mailing Address - Phone:561-406-6574
Mailing Address - Fax:561-203-2769
Practice Address - Street 1:3535 MILITARY TRL
Practice Address - Street 2:#204
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5009
Practice Address - Country:US
Practice Address - Phone:561-406-6574
Practice Address - Fax:561-203-2769
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2014-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME1040012086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery