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NPI Code Detail

MEDICARE: JACK D. NORMAN, M.D., P.A.

MEDICARE: JACK D. NORMAN, M.D., P.A.
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
12086S0122XPlastic and Reconstructive Surgery Physician

General Provider Information

NPI Number : 1710284062
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACK D. NORMAN, M.D., P.A.
Provider Business Mailing Address
First Line : 848 BRICKELL AVE
Second Line : SUITE #820
City : MIAMI
State : FL
Zip : 33131-2949
Country : US
Telephone Number : 305-358-7110
Fax Number : 305-379-6777
Provider Business Practice Location Address
First Line : 848 BRICKELL AVE
Second Line : SUITE #820
City : MIAMI
State : FL
Zip : 33131-2949
Country : US
Telephone Number : 305-358-7110
Fax Number : 305-379-6777
Authorized Official
Title or Position : OWNER
Name : MR. JACK D NORMAN
Credential : M.D.
Telephone Number : 305-667-1224
Provider Enumeration Date : 02/23/2011
Last Update Date : 02/23/2011

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