Provider Demographics
NPI:1356517767
Name:WHITE, JEREMY BOYD (MD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:BOYD
Last Name:WHITE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20950 NE 27TH CT STE 302
Mailing Address - Street 2:ARC PLASTIC SURGERY
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1232
Mailing Address - Country:US
Mailing Address - Phone:305-501-2000
Mailing Address - Fax:954-603-1151
Practice Address - Street 1:20950 NE 27TH CT STE 302
Practice Address - Street 2:ARC PLASTIC SURGERY
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1232
Practice Address - Country:US
Practice Address - Phone:305-501-2000
Practice Address - Fax:954-603-1151
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116019049390200000X
FLME107157207YX0905X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery