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General NPI Number Information
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NPI Number | 1568621522
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Entity Type | Organization
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Legal Business Name | JOHN J. O'BRIEN, JR., M.D., P.A.
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 7855 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1134
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Country | US
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Telephone | 727-341-2408
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Fax | 727-341-2708
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Provider Business Mailing Address
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Address Line | 7855 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1134
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Country | US
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Telephone | 727-341-2408
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Fax | 727-341-2708
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Authorized Official
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Title or Position | BILLING DEPARTMENT
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Name | MS. COLLEEN M O'BRIEN
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Credential |
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Telephone | 727-341-2408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | ME0066063
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License Number State | FL
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