Provider Demographics
NPI:1003896598
Name:NOBEL, JOHN C (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:NOBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3450 E FLETCHER AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4655
Mailing Address - Country:US
Mailing Address - Phone:813-971-2424
Mailing Address - Fax:813-971-2420
Practice Address - Street 1:3450 E FLETCHER AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4655
Practice Address - Country:US
Practice Address - Phone:813-971-2424
Practice Address - Fax:813-971-2420
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0037141207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30488OtherBCBS
FL60046957OtherMEDICARE RAILROAD
FL2505049OtherUNITED HEALTHCARE
FL4092977OtherAETNA
FL30488AMedicare ID - Type Unspecified
FL30488OtherBCBS