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NPI Code Detail

MEDICARE: JOHN EDWARD PURPURA DDS

MEDICARE:   JOHN EDWARD PURPURA  DDS
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
11223G0001XGeneral Practice DentistryDN23539FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255506218
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN EDWARD PURPURA DDS
Provider Business Mailing Address
First Line : 1645 E HIGHWAY 50 STE 100
Second Line :
City : CLERMONT
State : FL
Zip : 34711-5199
Country : US
Telephone Number : 352-242-6222
Fax Number :
Provider Business Practice Location Address
First Line : 1645 E HIGHWAY 50 STE 100
Second Line :
City : CLERMONT
State : FL
Zip : 34711-5199
Country : US
Telephone Number : 352-242-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2008
Last Update Date : 12/18/2019

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Directions to “ JOHN EDWARD PURPURA DDS” Practice Location

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