MEDICARE: DAVID H JABLONSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	ME65714	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134115819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID H JABLONSKI M.D.

Provider Business Mailing Address
First Line	:	865 OAKLEY SEAVER DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1968
Country	:	US
Telephone Number	:	877-876-3627
Fax Number	:	321-843-4101

Provider Business Practice Location Address
First Line	:	865 OAKLEY SEAVER DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1968
Country	:	US
Telephone Number	:	877-876-3627
Fax Number	:	321-843-4101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	12/12/2016

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