Provider Demographics
NPI:1699769091
Name:JEFFREY SKLAR MD PA
Entity type:Organization
Organization Name:JEFFREY SKLAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:941-475-9559
Mailing Address - Street 1:2650 S MCCALL RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-6400
Mailing Address - Country:US
Mailing Address - Phone:941-475-9559
Mailing Address - Fax:941-473-7515
Practice Address - Street 1:2650 S MCCALL RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-6400
Practice Address - Country:US
Practice Address - Phone:941-475-9559
Practice Address - Fax:941-473-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046282207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62031OtherBCBS
FL62031OtherBCBS
FL33312Medicare ID - Type UnspecifiedGROUP NUMBER