Individual
DR. JEFFREY STUART PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 JOHN F KENNEDY DR STE 201, ATLANTIS, FL 33462-1142
(561) 967-4400
(561) 967-5277
Mailing address
900 VILLAGE SQUARE XING, STE 170, PALM BEACH GARDENS, FL 33410-4547
(561) 967-4400
(561) 967-5277
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME0030380
FL
207X00000X
Orthopaedic Surgery Physician
Primary
ME30380
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037798800
—
FL
01
—
206593
AVMED
FL
01
—
50805
BCBS
FL
Enumeration date
09/21/2006
Last updated
01/27/2022
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