Individual
EVERETT SCHUYLER DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 E NASA BLVD, MELBOURNE, FL 32901-1950
(321) 361-5624
(321) 728-8649
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5624
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME77782
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268183800
—
FL
01
—
79765Y
MEDICARE
FL
Enumeration date
10/26/2005
Last updated
12/05/2024
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