Wilson, Jeffrey Lynn
Wilson, Jeffrey Lynn is an sole proprietor health care provider with primary practice located at 1810 Eldron Blvd., Se , Palm Bay FL 32909. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Jeffrey Lynn can be contacted via phone (321) 434-3430.Contact Information
Primary practice address
1810 Eldron Blvd., Se
Palm Bay FL 32909
Phone: (321) 434-3430
Fax: (321) 434-3432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS14088 | Florida |
Profile Details
| NPI number | 1922108745 |
|---|---|
| LBN Legal business name | Wilson, Jeffrey Lynn |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Aug 24th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922108745 | NPPES |
| Florida | Other | IS227Z | FL MEDICARE |
| Florida | MEDICAID | 019335700 | FL MEDICARE |
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