Provider Demographics
NPI:1962571752
Name:JASPER, JOSEPHINE VINCENZA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:VINCENZA
Last Name:JASPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-6703
Mailing Address - Country:US
Mailing Address - Phone:239-315-8271
Mailing Address - Fax:239-970-0446
Practice Address - Street 1:40 S HEATHWOOD DR STE E
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-5026
Practice Address - Country:US
Practice Address - Phone:239-315-8271
Practice Address - Fax:239-970-0446
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05391900207RE0101X
FLME128241207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
65159OtherAETNA
FLD40WFOtherBCBS OF FLORIDA
NJE83111Medicare UPIN
65159OtherAETNA