1922011147 NPI number — JAY P KUMAR MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922011147 NPI number — JAY P KUMAR MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAY P KUMAR MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922011147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 21727
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33622-1727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-823-2188
Provider Business Mailing Address Fax Number:
727-823-9502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10075 CORTEZ BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKSVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-597-6600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUMAR
Authorized Official First Name:
JAY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER / PROVIDER
Authorized Official Telephone Number:
352-597-6600

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DH2445 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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