Provider Demographics
NPI:1437148574
Name:TRUE, JEFFREY A (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:TRUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:239 N RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-1734
Mailing Address - Country:US
Mailing Address - Phone:386-427-9901
Mailing Address - Fax:386-427-1926
Practice Address - Street 1:239 N RIDGEWOOD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-1734
Practice Address - Country:US
Practice Address - Phone:386-427-9901
Practice Address - Fax:386-427-9935
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0051070207Q00000X
FLME51070208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04302OtherBCBS
FL046123700Medicaid
FLME0051070OtherVHN
FLME0051070OtherBEECHSTREET
FLME0051070OtherUNITED BENEFITS
FL80171373OtherRAILROAD
FL04302OtherBCBS
FLME0051070OtherBEECHSTREET