Provider Demographics
NPI:1346369741
Name:MCFARLANE, JOHN TREVOR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TREVOR
Last Name:MCFARLANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 JUNE DR
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3233
Mailing Address - Country:US
Mailing Address - Phone:321-784-4355
Mailing Address - Fax:
Practice Address - Street 1:2400 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4127
Practice Address - Country:US
Practice Address - Phone:321-454-4007
Practice Address - Fax:321-576-0257
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME19482207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E14541Medicare UPIN
FL91470Medicare ID - Type Unspecified