Provider Demographics
NPI:1518913292
Name:STEINBAUM, JEREMY DON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:DON
Last Name:STEINBAUM
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 1:2864 WELLNESS AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8395
Mailing Address - Country:US
Mailing Address - Phone:386-775-0333
Mailing Address - Fax:
Practice Address - Street 1:2864 WELLNESS AVE
Practice Address - Street 2:STE 200
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8395
Practice Address - Country:US
Practice Address - Phone:386-775-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME689692086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2010619OtherAETNA
FL27523OtherBCBS
FL378975600Medicaid
FL27523YMedicare ID - Type Unspecified
FL2010619OtherAETNA