Provider Demographics
NPI:1225149891
Name:JAYSON, MAURY A (MD)
Entity Type:Individual
Prefix:
First Name:MAURY
Middle Name:A
Last Name:JAYSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD STE 308
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1010
Mailing Address - Country:US
Mailing Address - Phone:954-392-7770
Mailing Address - Fax:954-392-7577
Practice Address - Street 1:601 N FLAMINGO RD STE 308
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1010
Practice Address - Country:US
Practice Address - Phone:954-392-7770
Practice Address - Fax:954-392-7577
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84787208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4637949OtherCIGNA PROVIDER NUMBER
FL473460OtherNHP
FL292536OtherAVMED
FL354725OtherSTAYWELL
NY1001006OtherGHI PROVIDER NUMBER
NYP391768OtherOXFORD PROVIDER NUMBER
FL354725OtherWELLCARE
FL4658368OtherAETNA
FL82012OtherBC/BS PROVIDER NUMBER
FL1779748OtherAETNA
FL269261900Medicaid
FL82012AMedicare PIN
FL82012OtherBC/BS PROVIDER NUMBER
FL4637949OtherCIGNA PROVIDER NUMBER