Provider Demographics
NPI:1770711681
Name:LOCH, ELI STEVEN (DO)
Entity type:Individual
Prefix:DR
First Name:ELI
Middle Name:STEVEN
Last Name:LOCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:705 WELLS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-2982
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-619-1080
Practice Address - Street 1:463386 S.R. 200
Practice Address - Street 2:UNIT A
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097
Practice Address - Country:US
Practice Address - Phone:904-468-3080
Practice Address - Fax:904-468-3193
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO#: 2122207L00000X
FLOS12026207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011838700Medicaid
FL14U2VOtherBCBS
FLHT303ZMedicare PIN