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General NPI Number Information
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NPI Number | 1790916369
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Entity Type | Organization
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Legal Business Name | EDGARD JANER MD PA
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 3411 W FLETCHER AVE STE A
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City | TAMPA
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State | FL
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Zip | 33618-2813
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Country | US
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Telephone | 813-962-4119
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Fax | 813-962-3278
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Provider Business Mailing Address
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Address Line | PO BOX 342159
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City | TAMPA
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State | FL
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Zip | 33694
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Country | US
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Telephone | 813-962-4119
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Fax | 813-962-3278
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDGARD JANER
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Credential | MD
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Telephone | 813-962-4119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME0065277
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License Number State | FL
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