Provider Demographics
NPI:1316372816
Name:JALBERT, EUGENE ROLAND II (DO)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:ROLAND
Last Name:JALBERT
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4701
Mailing Address - Country:US
Mailing Address - Phone:850-215-6400
Mailing Address - Fax:850-215-4440
Practice Address - Street 1:3890 JENKS AVENE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4701
Practice Address - Country:US
Practice Address - Phone:850-215-6400
Practice Address - Fax:850-215-4440
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS2884207RR0500X
FLOS12884207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL126293800Medicaid
FLIC429ZMedicare PIN