Provider Demographics
NPI:1841224797
Name:MEEROFF, J.C. (MD, PA)
Entity Type:Individual
Prefix:
First Name:J.C.
Middle Name:
Last Name:MEEROFF
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 N FEDERAL HWY
Mailing Address - Street 2:SUITE 202 EAST
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4618
Mailing Address - Country:US
Mailing Address - Phone:954-771-9297
Mailing Address - Fax:954-771-9913
Practice Address - Street 1:4801 N FEDERAL HWY
Practice Address - Street 2:SUITE 202 EAST
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4618
Practice Address - Country:US
Practice Address - Phone:954-771-9297
Practice Address - Fax:954-771-9913
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41305207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372960500Medicaid
D79579Medicare UPIN
FL372960500Medicaid