Provider Demographics
NPI:1427147115
Name:WORRALL, JASON A (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:A
Last Name:WORRALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 SW 7TH ST STE 2305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2964
Mailing Address - Country:US
Mailing Address - Phone:305-419-0313
Mailing Address - Fax:
Practice Address - Street 1:175 SW 7TH ST STE 2305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2964
Practice Address - Country:US
Practice Address - Phone:305-419-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0299290OtherBLUE SHIELD
CADC0299290OtherBLUE SHIELD
CAV07702Medicare UPIN