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Individual

MICHAEL R JAMPOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1095 NW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1719
(772) 785-5505
(772) 785-5571
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-5665
(772) 223-5646

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME72967
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
252942400
FL
Enumeration date
07/19/2006
Last updated
10/12/2020
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