Healthcare Provider Details
I. General information
NPI: 1992036933
Provider Name (Legal Business Name): DON N. LERNER, MD, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/14/2010
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
836 PRUDENTIAL DR STE 1802 SUITE 1802
JACKSONVILLE FL
32207-8345
US
IV. Provider business mailing address
836 PRUDENTIAL DR STE 1802 SUITE 1802
JACKSONVILLE FL
32207-8345
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: DR.
DON
LERNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 904-398-5301