Search › Florida › 104100000X
Jaclyn Wisor
NPI 1629570882 · on the registry since 2018 · sole proprietor
Practice
- Address
- 201 Bayside Blvd
Oldsmar, FL 34677 - Phone
- (727) 365-6674
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 222Q00000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-11-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida