MEDICARE: JOHN P WILKERSON JR. MD

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
1	207X00000X	Orthopaedic Surgery Physician	ME82518	FL
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	ME82518	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1285699397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN P WILKERSON JR. MD

Provider Business Mailing Address
First Line	:	P.O. BOX 431050
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33243-1060
Country	:	US
Telephone Number	:	305-669-4426
Fax Number	:	305-669-4183

Provider Business Practice Location Address
First Line	:	6705 RED ROAD
Second Line	:	SUITE 418
City	:	CORAL GABLES
State	:	FL
Zip	:	33143-3644
Country	:	US
Telephone Number	:	305-669-4426
Fax Number	:	305-669-4183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	02/26/2010

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Directions to “ JOHN P WILKERSON JR. MD” Practice Location

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