Provider Demographics
NPI:1063710036
Name:JEFFREY E. POILEY, M.D., P.A.
Entity type:Organization
Organization Name:JEFFREY E. POILEY, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:POILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-896-8861
Mailing Address - Street 1:324 E PAR ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4004
Mailing Address - Country:US
Mailing Address - Phone:407-896-8861
Mailing Address - Fax:
Practice Address - Street 1:324 E PAR ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4004
Practice Address - Country:US
Practice Address - Phone:407-896-8861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME12416207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1487713483OtherNPI -INDIVIDUAL
FL1487713483OtherNPI -INDIVIDUAL