Provider Demographics
NPI:1669626198
Name:DR JEFFERY W LOUX PA
Entity Type:Organization
Organization Name:DR JEFFERY W LOUX PA
Other - Org Name:FLORIDA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOUX
Authorized Official - Suffix:
Authorized Official - Credentials:RMA,
Authorized Official - Phone:727-546-4400
Mailing Address - Street 1:4900 95TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-3544
Mailing Address - Country:US
Mailing Address - Phone:727-546-4400
Mailing Address - Fax:727-541-6965
Practice Address - Street 1:4900 95TH AVE
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-3544
Practice Address - Country:US
Practice Address - Phone:727-546-4400
Practice Address - Fax:727-541-6965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS2985305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82920OtherMEDICARE PROVIDER
FL062719400Medicaid
FL062719400Medicaid