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General NPI Number Information
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NPI Number | 1316012214
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Entity Type | Organization
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Legal Business Name | JOHN A ONDREJICKA MD PA
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 700 3RD ST SUITE 301
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5072
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Country | US
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Telephone | 904-241-5331
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Fax | 904-270-0233
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Provider Business Mailing Address
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Address Line | 700 3RD ST SUITE 301
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5072
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Country | US
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Telephone | 904-241-5331
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Fax | 904-270-0233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A. ONDREJICKA
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Credential | MD
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Telephone | 904-241-5331
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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 | ME54154
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License Number State | FL
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