Healthcare Provider Details

I. General information

NPI: 1982623302
Provider Name (Legal Business Name): JESSE SINGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL PRIMARY CARE (110)
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

610 CLEMATIS ST APT 332
WEST PALM BEACH FL
33401-5398
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-7577
  • Fax: 561-422-7615
Mailing address:
  • Phone: 561-422-7577
  • Fax: 561-422-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberOS8324
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: