Provider Demographics
NPI:1437676434
Name:KUMAR JAYANT, U (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:U
Middle Name:
Last Name:KUMAR JAYANT
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:KUMAR
Other - Middle Name:
Other - Last Name:JAYANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PHD
Mailing Address - Street 1:703 N FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1006
Mailing Address - Country:US
Mailing Address - Phone:954-844-1402
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE # MC5026
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1443
Practice Address - Country:US
Practice Address - Phone:773-702-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.075394390200000X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty