Provider Demographics
NPI:1417945650
Name:FLEMING, JOHN S (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:133 BENMORE DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4143
Mailing Address - Country:US
Mailing Address - Phone:407-646-7070
Mailing Address - Fax:407-646-7757
Practice Address - Street 1:133 BENMORE DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4143
Practice Address - Country:US
Practice Address - Phone:407-646-7070
Practice Address - Fax:407-646-7757
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2010-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0012593207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044137600Medicaid
D5331Medicare UPIN
FL044137600Medicaid