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1902821044
JERALD GLENN COOPERSMITH
ST AUGUSTINE, FL
NPI
1902821044
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL ARNP9218067)
Enumeration Date
2006-07-12
Last Update Date
2007-07-08
Business Address
Mr. JERALD GLENN COOPERSMITH ARNP
1955 US HIGHWAY 1 S 200
ST AUGUSTINE, FL 32086-3708
Phone number: 904-829-8956
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Mailing Address
Mr. JERALD GLENN COOPERSMITH ARNP
51 RENWORTH LN
PALM COAST, FL 32164-6627
Phone number: 386-586-5314
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