Provider Demographics
NPI:1497029821
Name:JSLAYSON PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:JSLAYSON PROFESSIONAL ASSOCIATION
Other - Org Name:FLORIDA SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:SJ
Authorized Official - Last Name:LAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-279-5166
Mailing Address - Street 1:PO BOX 422203
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34742-2203
Mailing Address - Country:US
Mailing Address - Phone:407-279-5166
Mailing Address - Fax:407-279-5167
Practice Address - Street 1:1016 MANN ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4121
Practice Address - Country:US
Practice Address - Phone:407-279-5166
Practice Address - Fax:407-279-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty