Provider Demographics
NPI:1073880886
Name:JASON POZNER M.D., P.A.
Entity Type:Organization
Organization Name:JASON POZNER M.D., P.A.
Other - Org Name:SANCTUARY PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:N
Authorized Official - Last Name:POZNER MD PA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-367-9101
Mailing Address - Street 1:4800 N FEDERAL HWY
Mailing Address - Street 2:C101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5188
Mailing Address - Country:US
Mailing Address - Phone:561-367-9101
Mailing Address - Fax:561-367-9102
Practice Address - Street 1:4800 N FEDERAL HWY
Practice Address - Street 2:C101
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5188
Practice Address - Country:US
Practice Address - Phone:561-367-9101
Practice Address - Fax:561-367-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH04912Medicare UPIN