Healthcare Provider Details

I. General information

NPI: 1124082755
Provider Name (Legal Business Name): JEFFREY HARRY OPPENHEIMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 03/07/2023
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7805 NW BEACON SQUARE BLVD STE 103
BOCA RATON FL
33487-1396
US

IV. Provider business mailing address

7805 NW BEACON SQUARE BLVD STE 103
BOCA RATON FL
33487-1396
US

V. Phone/Fax

Practice location:
  • Phone: 800-964-4395
  • Fax:
Mailing address:
  • Phone: 800-964-4395
  • Fax: 561-325-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number072598
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number301111583
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberG55925
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number40508
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD00046622
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME60083
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number246231
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number042414-L
License Number StatePA
# 10
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number25MA05469000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: