Provider Demographics
NPI:1578648838
Name:SOUTH FLORIDA EAR NOSE AND THROAT PLLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA EAR NOSE AND THROAT PLLC
Other - Org Name:MICHAEL A. JAINDL, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAINDL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-674-7345
Mailing Address - Street 1:1530 LEE BLVD
Mailing Address - Street 2:STE 2350
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4893
Mailing Address - Country:US
Mailing Address - Phone:239-674-7345
Mailing Address - Fax:239-491-2347
Practice Address - Street 1:1530 LEE BLVD
Practice Address - Street 2:STE 2350
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4893
Practice Address - Country:US
Practice Address - Phone:239-674-7345
Practice Address - Fax:239-491-2347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 108882207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty