Organization
JONATHAN T PAINE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN T. PAINE M.D. (PRESIDENT)
(321) 727-2468
Entity
Organization
Contact information
Practice address
1305 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 727-2468
(321) 952-0163
Mailing address
1305 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 727-2468
(321) 952-0163
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
ME0050830
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03944
BLUE CROSS BLUE SHIELD
FL
05
—
046080000
—
FL
01
—
0470639
AETNA HMO
FL
01
—
140001058
RAILROAD MEDICARE
FL
01
—
4039014
AETNA PPO
FL
01
—
6656062002
CIGNA
FL
Enumeration date
02/14/2006
Last updated
03/25/2009
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