N Fred Eaglstein DO PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

N FRED EAGLSTEIN DO PA

Practice address

2055 Professional Center Dr
Orange Park, FL 32073-4461

Phone

(904) 276-4500

Fax

(904) 276-4160

NPI assigned

Aug 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

N Fred Eaglstein, DO

Title

Physician/Owner

Phone

(904) 276-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dermatology and Laser Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1679574164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 PROFESSIONAL CENTER DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734461",
            "telephone_number": "904-276-4500",
            "fax_number": "904-276-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 PROFESSIONAL CENTER DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734461",
            "telephone_number": "904-276-4500",
            "fax_number": "904-276-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N FRED EAGLSTEIN DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "EAGLSTEIN",
        "authorized_official_first_name": "N",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "904-276-4500",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043624100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology and Laser Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Pope Musser, M.A.
• Natasha Kae Musser, D.C.
• Maya Abby Myalil, RPH
• Myeyedr. Optometry of Florida, LLC
• Myeyedr. Optometry of Florida, LLC
• Hala Nabulsi
• Naja R Naddaf, M.D.
• Allen Nadeau, PA-C
• Muhammad Abubakar Nagra, M.B.B.S
• Leslie Nahinu, IBCLC

• Dermatology Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.