De Boer, Justin Adam
De Boer, Justin Adam is an individual health care provider with primary practice located at 60 W Gore St , Orlando FL 32806-1141. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. De Boer, Justin Adam can be contacted via phone (321) 841-3338.Contact Information
Primary practice address
60 W Gore St
Orlando FL 32806-1141
Phone: (321) 841-3338
Fax: (321) 841-2170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | ME134140 | Florida |
Profile Details
| NPI number | 1104184027 |
|---|---|
| LBN Legal business name | De Boer, Justin Adam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2012 |
| Last updated | Jun 20th, 2019 - about 7 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 | 1104184027 | NPPES |
| Florida | MEDICAID | 102833800 |
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