Individual
DR. JACOB JANUSZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2222 S HARBOR CITY BLVD STE 610, MELBOURNE, FL 32901-5591
(321) 723-7716
(321) 723-0604
Mailing address
2222 S HARBOR CITY BLVD STE 610, MELBOURNE, FL 32901-5591
(321) 723-7716
(321) 723-0604
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
OS14529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021089200
—
FL
01
—
1143045
CAREPLUS
FL
01
—
1531493
WELLCARE
FL
01
—
4762182
AETNA
FL
01
—
9076362
CIGNA
FL
01
—
W9TNA
FLORIDA BLUE
FL
Enumeration date
03/18/2011
Last updated
01/21/2019
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