Healthcare Provider Details

I. General information

NPI: 1437447471
Provider Name (Legal Business Name): JOHN S POSER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12921 SW 1ST RD STE 219
TIOGA FL
32669-5709
US

IV. Provider business mailing address

12921 SW 1ST RD STE 219
TIOGA FL
32669-5709
US

V. Phone/Fax

Practice location:
  • Phone: 352-372-3672
  • Fax: 352-378-1117
Mailing address:
  • Phone: 352-372-3672
  • Fax: 352-378-1117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME41976
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN SHEARER POSER
Title or Position: OWNER
Credential: MD
Phone: 352-372-3672