| Miguel Dejuk, Pc | |
|
800 Zeagler Dr Ste 210 Palatka FL 32177-3827 | |
| (386) 328-8668 | |
| (386) 328-3767 |
| Full Name | Miguel Dejuk, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 Zeagler Dr Ste 210, Palatka, Florida |
| Authorized Official Name and Position | Miguel Gazel Dejuk (OWNER) |
| Authorized Official Contact | 3863288668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miguel Dejuk, Pc 800 Zeagler Dr Ste 210 Palatka FL 32177-3827 Ph: (386) 328-8668 | Miguel Dejuk, Pc 800 Zeagler Dr Ste 210 Palatka FL 32177-3827 Ph: (386) 328-8668 |
| NPI Number | 1457634263 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 03/02/2012 |
| Medicare PECOS PAC ID | 4587823877 |
|---|---|
| Medicare Enrollment ID | O20120306000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457634263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | ME 0055591 (Florida) | Primary |
| Provider Name | Miguel G Dejuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912070269 PECOS PAC ID: 3476681487 Enrollment ID: I20100512000995 |
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