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General NPI Number Information
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NPI Number | 1811939614
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Entity Type | Individual
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Provider Name | JERALD REINSHAGEN MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 902 N DIXIE FWY
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-6220
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Country | US
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Telephone | 386-663-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 100 ARRICOLA AVE
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-4515
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Country | US
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Telephone | 904-825-4368
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 13845
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME147037
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License Number State | FL
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