Healthcare Provider Details

I. General information

NPI: 1184687162
Provider Name (Legal Business Name): JEFFREY W SKIMMING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 12/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 N COMMERCE PKWY SUITE 1
WESTON FL
33326-3250
US

IV. Provider business mailing address

1500 CONCORD TER
SUNRISE FL
33323-2815
US

V. Phone/Fax

Practice location:
  • Phone: 954-385-5545
  • Fax: 954-385-7758
Mailing address:
  • Phone: 800-243-3839
  • Fax: 855-527-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME 116069
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: