Provider Demographics
NPI:1487640645
Name:OKEECHOBEE EMERGENCY PHYSICIANS INC
Entity Type:Organization
Organization Name:OKEECHOBEE EMERGENCY PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ADELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-232-9032
Mailing Address - Street 1:1607 NW FEDERAL HWY
Mailing Address - Street 2:#B
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9600
Mailing Address - Country:US
Mailing Address - Phone:772-232-9032
Mailing Address - Fax:772-232-9211
Practice Address - Street 1:1796 HIGHWAY 441 N
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1918
Practice Address - Country:US
Practice Address - Phone:772-232-9032
Practice Address - Fax:772-232-9211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34318Medicare ID - Type Unspecified