Healthcare Provider Details

I. General information

NPI: 1063710036
Provider Name (Legal Business Name): JEFFREY E. POILEY, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 E PAR ST
ORLANDO FL
32804-4004
US

IV. Provider business mailing address

324 E PAR ST
ORLANDO FL
32804-4004
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-8861
  • Fax:
Mailing address:
  • Phone: 407-896-8861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME12416
License Number StateFL

VIII. Authorized Official

Name: DR. JEFFREY E. POILEY
Title or Position: MEDICAL DOCTOR/OWNER
Credential: M.D.
Phone: 407-896-8861