Provider Demographics
NPI:1942251764
Name:JARBOE, JOHN AUSTIN III (ARNP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:AUSTIN
Last Name:JARBOE
Suffix:III
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13020 PARK BLVD
Mailing Address - Street 2:OAKHURST MEDICAL CLINIC
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776
Mailing Address - Country:US
Mailing Address - Phone:727-393-3404
Mailing Address - Fax:727-393-4814
Practice Address - Street 1:13020 PARK BLVD
Practice Address - Street 2:OAKHURST MEDICAL CLINIC
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776
Practice Address - Country:US
Practice Address - Phone:727-393-3404
Practice Address - Fax:727-393-4814
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3308662363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7672ZMedicare PIN
FLE7672VMedicare PIN
FLE7672WMedicare PIN
P62550Medicare UPIN
FLE7672YMedicare PIN