John H Potomski JR.
Geriatric Medicine
720 E New Haven Ave
Melbourne
, Florida 32901
John H Potomski JR.
Geriatric Medicine
720 E New Haven Ave
Melbourne
, Florida 32901
(321) 728-4168
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- John H Potomski JR.
- 720 E New Haven Ave Ste 11
- Melbourne, FL
- Zip : 32901-5474
- Fax : (321) 728-4168
- Phone : (321) 724-4545
Second Address
- John H Potomski JR.
- 720 E New Haven Ave
- Melbourne, FL
- Zip : 32901
- Fax : (321) 728-4168
- Phone : (321) 724-4545
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | OS4425 | FL |
National Provider Identifier
| NPI | 1083657183 |
|---|---|
| Provider Name | John H Potomski JR. |
| First Address | Melbourne, FL 32901-5474 |
| Second Address | Melbourne, FL 32901 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/06/2006 |
| Last Update Date | 04/10/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 067596200 | (05) | FL |
| E32256 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.