Individual
DR. JAMES JANOUSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 PINEWOOD WAY SW, LIVE OAK, FL 32064-4054
(386) 364-4101
(386) 364-5145
Mailing address
801 PINEWOOD WAY SW, LIVE OAK, FL 32064
(386) 364-4101
(386) 364-5145
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
0030682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02017
BLUE CROSS BLUE SHIELD
FL
05
—
058729000
—
FL
01
—
100440
AVMED
FL
Enumeration date
07/03/2006
Last updated
03/07/2018
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