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General NPI Number Information
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NPI Number | 1053656561
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Entity Type | Individual
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Provider Name | JEREMY SCOTT BLEICHER D.O., MPH
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Gender | Male
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 1380 NE MIAMI GARDENS DR STE 155
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4747
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Country | US
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Telephone | 305-902-1663
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Fax | 786-578-0232
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Provider Business Mailing Address
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Address Line | 1380 NE MIAMI GARDENS DR STE 155
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4747
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Country | US
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Telephone | 305-431-2680
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Fax | 786-578-0232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS12010
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | OS12010
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License Number State | FL
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