Basic Information
| Provider Information | |||||||||
| NPI: | 1598812521 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUELLER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 LOUISIANA AVE | ||||||||
| Address2: | SUITE E | ||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327892340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076442990 | ||||||||
| FaxNumber: | 4076444370 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 LOUISIANA AVE | ||||||||
| Address2: | SUITE E | ||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327892340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076442990 | ||||||||
| FaxNumber: | 4076444370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 08/23/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME61985 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.