Provider Demographics
NPI:1851574149
Name:JEFFREY T. HAIMES, M.D.
Entity Type:Organization
Organization Name:JEFFREY T. HAIMES, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAIMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-753-3600
Mailing Address - Street 1:1710 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6090
Mailing Address - Country:US
Mailing Address - Phone:954-753-3600
Mailing Address - Fax:954-755-0916
Practice Address - Street 1:1710 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6090
Practice Address - Country:US
Practice Address - Phone:954-753-3600
Practice Address - Fax:954-755-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL49462207X00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0452910001Medicare NSC