Individual
PETER JOHN JAFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1865 VETERANS PARK DR, SUITE # 101, NAPLES, FL 34109-0447
(239) 254-7778
(239) 254-7718
Mailing address
PO BOX 111090, NAPLES, FL 34108-0119
(239) 254-7778
(239) 254-7718
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS8375
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223383833
TAX IDENTIFICATION NUMBER
FL
01
—
51541
BLUE CROSS BLUE SHIELD
FL
01
—
DMERC
4736770002
FL
01
—
OS8375
STATE LICENSE
FL
01
—
RAILROAD MEDICARE
250014152
FL
Enumeration date
01/17/2007
Last updated
04/14/2023
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