Provider Demographics
NPI:1598812521
Name:MUELLER, JEFFREY A (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:MUELLER
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 1:1201 LOUISIANA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2340
Mailing Address - Country:US
Mailing Address - Phone:407-644-2990
Mailing Address - Fax:407-644-4370
Practice Address - Street 1:1201 LOUISIANA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2340
Practice Address - Country:US
Practice Address - Phone:407-644-2990
Practice Address - Fax:407-644-4370
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61985208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice