Individual
JORG A BOBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1409 KINGSLEY AVE, SUITE 9-G, ORANGE PARK, FL 32073-4537
(904) 637-0037
Mailing address
PO BOX 1653, ORANGE PARK, FL 32067-1653
(904) 422-1566
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
PO3294
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3942
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002908200
—
FL
01
—
65967
BCBS
FL
01
—
6605219
CIGNA
FL
01
—
7923937
AETNA
FL
01
—
PO3294
FL STATE LICENSE
FL
Enumeration date
03/30/2007
Last updated
03/01/2011
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