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Individual

JONATHAN T. PAINE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1305 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 727-2468
(321) 952-0163
Mailing address
1305 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 727-2468
(321) 952-0163

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
ME0050830
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03944
BLUE CROSS BLUE SHIELD, F
FL
01
0470639
AETNA HMO
FL
01
4039014
AETNA PPO
FL
01
6656062002
CIGNA
FL
Enumeration date
02/14/2006
Last updated
07/08/2007
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