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Individual

DR. JEREMY MCCONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5717 21ST AVE WEST, BRADENTON, FL 34209
(941) 792-8383
(941) 792-8484
Mailing address
5717 21ST AVE WEST, BRADENTON, FL 34209
(941) 792-8383
(941) 792-8484

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME83356
FL
207QB0002X
Obesity Medicine (Family Medicine) Physician
ME83356
FL
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
ME83356
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1700871969
NPI
FL
05
266997800
FL
Enumeration date
09/14/2005
Last updated
11/29/2021
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