Individual
DR. JONATHAN JAY LUBITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5005 PORT ST JOHN PKWY, SUITE 2100, PORT SAINT JOHN, FL 32927-4305
(321) 433-2247
(321) 635-9310
Mailing address
805 CENTURY MEDICAL DR, SUITE C, TITUSVILLE, FL 32796-2100
(321) 268-6264
(321) 635-9310
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO1452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004278200
—
FL
Enumeration date
06/13/2005
Last updated
06/09/2015
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