# JEREMY D. MCCONNELL, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841644358
- **Authorized official:** DR. JEREMY DAVID MCCONNELL MD (PRESIDENT)
- **Authorized official phone:** (813) 404-0159

## Contact information

- **Practice address:** 5717 21ST AVE W, BRADENTON, FL 34209
- **Practice address phone:** (941) 792-8383
- **Practice address fax:** (941) 792-8484
- **Mailing address:** 5717 21ST AVE W, BRADENTON, FL 34209
- **Mailing address phone:** (941) 792-8383
- **Mailing address fax:** (941) 792-8484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME83356 | FL | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | ME83356 | FL | — |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | ME83356 | FL | Yes |

## Other

- **Enumeration date:** 04/20/2016
- **Last updated:** 11/19/2021