Organization
GEORGE E PLATT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BOGAN (PRESIDENT)
(904) 962-2123
Entity
Organization
Contact information
Practice address
705 FERRIS ST, GREEN COVE SPRINGS, FL 32043-4025
(904) 284-4510
(904) 284-3293
Mailing address
PO BOX 10890, JACKSONVILLE, FL 32247-0890
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME54692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015482
OTHER ID NUMBER
—
Enumeration date
06/15/2006
Last updated
01/22/2008
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