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Individual

DR. JONATHAN THOMAS DEGROAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6531 CHANNELSIDE DR, NEW PORT RICHEY, FL 34652-2061
(941) 725-1868
Mailing address
6531 CHANNELSIDE DR, NEW PORT RICHEY, FL 34652-2061
(941) 725-1868

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME114356
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009326800
FL
Enumeration date
06/15/2010
Last updated
01/19/2014
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