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General NPI Number Information
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NPI Number | 1245770163
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Entity Type | Individual
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Provider Name | JANE ELPEDES LONGARES M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 7301A W PALMETTO PARK RD STE 306A
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City | BOCA RATON
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State | FL
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Zip | 33433-3466
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Country | US
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Telephone | 561-571-0404
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Fax | 561-462-0859
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Provider Business Mailing Address
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Address Line | 7050 W PALMETTO PARK RD STE 15-840
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City | BOCA RATON
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State | FL
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Zip | 33433-3426
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Country | US
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Telephone | 561-571-0404
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Fax | 561-462-0859
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME157194
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License Number State | FL
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