John Ezra Trainer in Jacksonville - Adolescent Medicine
John Ezra Trainer - NPI 1699770990
John Ezra Trainer is a Adolescent Medicine in Jacksonville, Florida. John Ezra Trainer practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for John Ezra Trainer is 1699770990. The last update date is 2022-12-02.
John Ezra Trainer's current location address is 6841 Blanding Blvd, Jacksonville, Florida. You can contact this provider via phone number 9048622175 and fax number 9048622175. The mailing address for John Ezra Trainer is 6841 Blanding Blvd, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Ezra Trainer |
|---|---|
| Address | 6841 Blanding Blvd, Jacksonville, Florida |
| Phone Number | 9048622175 |
| Fax Number | 9048622175 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1699770990 |
|---|---|
| Provider Enumeration Date | 2005-06-15 |
| Last Updated Date | 2022-12-02 |
Provider Mailing Address Detail
| Address | 6841 Blanding Blvd |
|---|---|
| City | Jacksonville |
| State | Florida (FL) |
| Post Code | 3224444180 |
| Phone Number | 9048622175 |
| Fax Number | 9048622175 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 207Qa0000X |
| Licence No | ME80458 |
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Definition: A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 101586800 | FL | -- |
Post Comment/ Review Below
What is the unique identifier code issued to John Ezra Trainer by the Centers for Medicare & Medicaid Services (CMS)?
The John Ezra Trainer has been assigned the NPI (National Provider Identifier) 1699770990. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the John Ezra Trainer located?
The John Ezra Trainer is located at 6841 Blanding Blvd, Jacksonville, FL 3224444180.
What is John Ezra Trainer's area of expertise and its corresponding taxonomy classification?
The John Ezra Trainer's field of specialization is Adolescent Medicine, and it falls under the taxonomy code 207Qa0000X, which categorizes healthcare providers based on their areas of practice.
On what date did the John Ezra Trainer receive the assignment of its 1699770990 from the Centers for Medicare & Medicaid Services?
The John Ezra Trainer was issued its 1699770990 by the Centers for Medicare & Medicaid Services on 2005-06-15.
As of what date were the details pertaining to John Ezra Trainer last refreshed?
The information related to the John Ezra Trainer, including its address, specialty, and other relevant details, was last updated on 2022-12-02.