| Dr Jesse Seth Greenblum, MD | |
|
1411 S 14th St, Suite B, Fernandina Beach, FL 32034-3031 | |
| (904) 261-5605 | |
| (904) 277-0725 |
| Full Name | Dr Jesse Seth Greenblum |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 1411 S 14th St, Fernandina Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265547103 | NPI | - | NPPES |
| 00395117A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | ME45241 (Florida) | Primary |
| Entity Name | Halifax Healthcare Systems Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245283530 PECOS PAC ID: 1254238090 Enrollment ID: O20031218000443 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jesse Seth Greenblum, MD 1411 S 14th St, Suite B, Fernandina Beach, FL 32034-3031 Ph: (904) 261-5605 | Dr Jesse Seth Greenblum, MD 1411 S 14th St, Suite B, Fernandina Beach, FL 32034-3031 Ph: (904) 261-5605 |
Mrs. Agata Nelson, LM Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 910 S 8th St, Suite 100, Fernandina Beach, FL 32034 Phone: 904-875-4278 Fax: 904-572-1571 | |
Edmund William Mcgrath Jr., M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1411 S 14th St Ste D, Fernandina Beach, FL 32034 Phone: 904-321-0064 Fax: 904-491-3113 |