Healthcare Provider Details

I. General information

NPI: 1487640645
Provider Name (Legal Business Name): OKEECHOBEE EMERGENCY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1796 HIGHWAY 441 N
OKEECHOBEE FL
34972-1918
US

IV. Provider business mailing address

1607 NW FEDERAL HWY #B
STUART FL
34994-9600
US

V. Phone/Fax

Practice location:
  • Phone: 772-232-9032
  • Fax: 772-232-9211
Mailing address:
  • Phone: 772-232-9032
  • Fax: 772-232-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: JONATHAN MICHAEL ADELBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 772-232-9032