Provider Demographics
NPI:1649668641
Name:JABLONSKI, JANET (MD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 PARK LAKE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3908
Mailing Address - Country:US
Mailing Address - Phone:407-648-2623
Mailing Address - Fax:
Practice Address - Street 1:856 PARK LAKE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3908
Practice Address - Country:US
Practice Address - Phone:407-648-2623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0065638172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker