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NPI Code Detail

MEDICARE: DR. JEFFREY D BRECKENRIDGE MD

MEDICARE: DR. JEFFREY D BRECKENRIDGE 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
1207Q00000XFamily Medicine Physician01045525AIN
2207P00000XEmergency Medicine Physician01045525AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000033416OTHERMPLAN
2000000382235OTHERINANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982672069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY D BRECKENRIDGE MD
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5430 E WASHINGTON ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-6446
Country : US
Telephone Number : 317-969-7935
Fax Number : 877-550-2158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 11/03/2025

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