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NPI Code Detail

MEDICARE: JENSEN BEACH FAMILY PRACTICE, INC

MEDICARE: JENSEN BEACH FAMILY PRACTICE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME68270FL

General Provider Information

NPI Number : 1073940151
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENSEN BEACH FAMILY PRACTICE, INC
Provider Business Mailing Address
First Line : 3405 NW FEDERAL HWY
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-4439
Country : US
Telephone Number : 772-692-8082
Fax Number : 772-232-9211
Provider Business Practice Location Address
First Line : 3405 NW FEDERAL HWY
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-4439
Country : US
Telephone Number : 772-692-8082
Fax Number : 772-232-9211
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : DR. JONATHAN MICHAEL ADELBERG
Credential : M.D.
Telephone Number : 772-692-8082
Provider Enumeration Date : 10/03/2013
Last Update Date : 10/03/2013

Similar Medicare Providers

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1013390798 — MR. DAVID PAVCIK ARNP FNP BC
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1710486915 — CATHERINE DENT
Practice Location Address:
3405 NW FEDERAL HWY
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Directions to “JENSEN BEACH FAMILY PRACTICE, INC ” Practice Location

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