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JACK DEROVANESIAN MD
NPI 1073567186
Emergency Medicine in Naples, FL

Active since May 22, 2006
6400 DAVIS BLVD STE 103, NAPLES, FL 34104(239) 775-2300 Get Directions Write a Review

NPPES record last updated: May 12, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Derovanesian Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK DEROVANESIAN MD (NPI 1073567186) is an individual emergency medicine provider in Naples, Florida, licensed in Florida (ME26879) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1073567186
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJACK DEROVANESIANCredential: MD
Location Address6400 DAVIS BLVD STE 103Naples, FL 34104-5321
Mailing AddressPo Box 160448Miami, FL 33116-0448 · (239) 262-4519 · Fax (239) 262-5672
Phone(239) 775-2300
Sole ProprietorNo
Enumeration DateMay 22, 2006
Last NPPES UpdateMay 12, 2008
✔ NPI 1073567186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in FL · ME26879
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
6400 DAVIS BLVD STE 103, Naples, FL 34104
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Other Identifiers 7

Medicare PIN930118917
Medicare PIN78470T
Other78470FL · Bc Bs Fl
Medicaid067815500FL
Medicare PINP00196822
Medicare UPIND58504
Medicare PIN78470V

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL LARRY EAKER PA-C
Physician Assistant
6400 DAVIS BLVD STE 103
NAPLES, FL 34104
Collier County (239) 775-2300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Derovanesian's NPI number?

The NPI number for Jack Derovanesian is 1073567186. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Jack Derovanesian located?

Jack Derovanesian practices at 6400 Davis Blvd Ste 103, Naples, FL 34104. The listed phone number is (239) 775-2300.

What is Jack Derovanesian's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

When was this NPI record last updated?

The NPPES record for Jack Derovanesian was last updated on May 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.