Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 38614 | FL |
N | 111NI0900X | Internist | 38614 | FL |
Y | 207RG0300X | Geriatric Medicine | 38614 | FL |
NPI | 1104854900 |
---|---|
Provider Name | Dr. John R Meuleman |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 23/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
067600400 | (05) | FL |
D57856 | (02) |