MEDICARE: JAMES JETROW PRESLEY M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME59303	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	:	1386604395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES JETROW PRESLEY M.D.

Provider Business Mailing Address
First Line	:	9576 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-4217
Country	:	US
Telephone Number	:	772-337-4000
Fax Number	:	844-543-0396

Provider Business Practice Location Address
First Line	:	9576 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-4217
Country	:	US
Telephone Number	:	772-337-4000
Fax Number	:	844-543-0396

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	01/21/2026

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