Provider Demographics
NPI:1477644169
Name:YAUDEGIS, JAY A (CRNA)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:A
Last Name:YAUDEGIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:A
Other - Last Name:A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:120 LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2606
Mailing Address - Country:US
Mailing Address - Phone:727-584-8489
Mailing Address - Fax:
Practice Address - Street 1:1501 S PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-1955
Practice Address - Country:US
Practice Address - Phone:727-937-6020
Practice Address - Fax:727-934-1250
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9241764367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered