Provider Demographics
NPI:1164600821
Name:JEFFREY H. FELD, M.D., P.A.
Entity Type:Organization
Organization Name:JEFFREY H. FELD, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:FELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-521-3520
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:SUITE 395
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3498
Mailing Address - Country:US
Mailing Address - Phone:407-521-3520
Mailing Address - Fax:407-521-3524
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:SUITE 395
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3498
Practice Address - Country:US
Practice Address - Phone:407-521-3520
Practice Address - Fax:407-521-3524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057911174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE61825Medicare UPIN