Provider Demographics
NPI:1013946862
Name:JELLINGER & LERMAN, MD, LLC
Entity Type:Organization
Organization Name:JELLINGER & LERMAN, MD, LLC
Other - Org Name:JELLING, NOVAK LERMAN, MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:JELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-963-7100
Mailing Address - Street 1:3107 STIRLING ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312
Mailing Address - Country:US
Mailing Address - Phone:954-963-7100
Mailing Address - Fax:954-337-2361
Practice Address - Street 1:3107 STIRLING ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312
Practice Address - Country:US
Practice Address - Phone:954-963-7100
Practice Address - Fax:954-337-2361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0022389207RE0101X
FLME0021354207RE0101X
FLME0022427207RE0101X
FLME86320207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14944OtherSAM LERMAN BC
FL14944BOtherMEDICARE PTAN
93115OtherPAUL JELLINGER BC
FLK9029OtherMEDICARE PTAN
FLU0056WOtherMEDICARE PTAN
FL93115BOtherMEDICARE PTAN
FLHR294ZOtherMEDICARE PTAN
93115OtherPAUL JELLINGER BC
F25688Medicare UPIN
D60334Medicare UPIN
H48376Medicare UPIN
78121OtherSTEPHEN NOVAK BC
93115OtherPAUL JELLINGER BC
93115BMedicare ID - Type UnspecifiedPAUL JELLINGER