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Organization

JONATHAN P. AXEL, M.D. PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN P AXEL M.D. (PRESIDENT)
(813) 413-9119
Entity
Organization

Contact information

Practice address
631 W LUMSDEN RD, BRANDON, FL 33511-5911
(813) 413-9119
(813) 413-9122
Mailing address
631 W LUMSDEN RD, BRANDON, FL 33511-5911
(813) 413-9119
(813) 413-9122

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME49689
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
062532900
FL
Enumeration date
07/14/2008
Last updated
02/04/2009
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