Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME0072870 | FL |
Y | 207X00000X | Orthopaedic Surgeon | ME72870 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME0072870 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME0072870 | FL |
NPI | 1003815812 |
---|---|
Provider Name | Dr. Michael V. Jablonski |
First Address | Lake Mary, FL 32746-4871 |
Second Address | Lake Mary, FL 32746-4871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 04/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01917 | BC/BS (01) | FL |
200042691 | RAILROAD (01) | FL |
265718000 | (05) | FL |
H26331 | (02) | FL |