Provider Demographics
NPI:1477662468
Name:FELD, JEFFREY H (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:FELD
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 1:10000 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
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057911207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063526000Medicaid
FL10672Medicare ID - Type Unspecified
FLE61825Medicare UPIN
FL063526000Medicaid
FL10672ZMedicare PIN