Provider Demographics
NPI:1417193806
Name:GURNANI, JAYA P (RPT)
Entity Type:Individual
Prefix:
First Name:JAYA
Middle Name:P
Last Name:GURNANI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3787 E GULF TO LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34453-3204
Mailing Address - Country:US
Mailing Address - Phone:352-341-1101
Mailing Address - Fax:352-726-7582
Practice Address - Street 1:3787 E GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3204
Practice Address - Country:US
Practice Address - Phone:352-341-1101
Practice Address - Fax:352-726-7582
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT92942251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884570100Medicaid
FL106924Medicare UPIN