Healthcare Provider Details
I. General information
NPI: 1548230170
Provider Name (Legal Business Name): DON N. LERNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/25/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
836 PRUDENTIAL DR SUITE 1802
JACKSONVILLE FL
32207-8334
US
IV. Provider business mailing address
836 PRUDENTIAL DR SUITE 1802
JACKSONVILLE FL
32207-8334
US
V. Phone/Fax
- Phone: 904-398-5301
- Fax: 904-398-1286
- Phone: 904-398-5301
- Fax: 904-398-1286
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YX0905X |
| Taxonomy | Otolaryngology/Facial Plastic Surgery Physician |
| License Number | ME65425 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: