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Individual

JOHN H POTOMSKI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO CMA

Contact information

Practice address
720 E NEW HAVEN AVE, MELBOURNE, FL 32901
(321) 724-4545
(321) 728-4168
Mailing address
720 E NEW HAVEN AVE STE 11, MELBOURNE, FL 32901-5474
(321) 724-4545
(321) 728-4168

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
OS4425
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
067596200
FL
Enumeration date
06/14/2006
Last updated
10/04/2019
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