| John Deagle Family Practice | |
|
90290 Overseas Hwy Suite 103 Tavernier FL 33070-2263 | |
| (305) 852-8208 | |
| (305) 852-2616 |
| Full Name | John Deagle Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 90290 Overseas Hwy, Tavernier, Florida |
| Authorized Official Name and Position | John Deagle (PRESIDENT) |
| Authorized Official Contact | 3058528208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Deagle Family Practice 90290 Overseas Hwy Suite 103 Tavernier FL 33070-2263 Ph: (305) 852-8208 | John Deagle Family Practice 90290 Overseas Hwy Suite 103 Tavernier FL 33070-2263 Ph: (305) 852-8208 |
| NPI Number | 1336499540 |
|---|---|
| Provider Enumeration Date | 09/14/2012 |
| Last Update Date | 09/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336499540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS06310 (Florida) | Primary |
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