Provider Demographics
NPI:1528322492
Name:SKORNICKI, JONAS (MD)
Entity type:Individual
Prefix:DR
First Name:JONAS
Middle Name:
Last Name:SKORNICKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JONAS
Other - Middle Name:
Other - Last Name:SKORNICKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2845 AVENTURA BLVD STE 245
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3120
Mailing Address - Country:US
Mailing Address - Phone:305-876-6662
Mailing Address - Fax:
Practice Address - Street 1:2845 AVENTURA BLVD STE 245
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3120
Practice Address - Country:US
Practice Address - Phone:305-876-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 113222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine