Provider Demographics
NPI:1508978032
Name:TRABIN, JAY R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:R
Last Name:TRABIN
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 1:8645 N MILITARY TRAIL
Mailing Address - Street 2:SUITE 508
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6296
Mailing Address - Country:US
Mailing Address - Phone:561-630-8001
Mailing Address - Fax:844-971-6855
Practice Address - Street 1:1405 SE GOLDTREE DR STE D
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7563
Practice Address - Country:US
Practice Address - Phone:772-800-7001
Practice Address - Fax:772-877-3539
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0030448207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50800OtherBLUECROSS BLUE SHIELD
FL50800OtherBLUECROSS BLUE SHIELD
FL50800OtherBLUECROSS BLUE SHIELD
FLD55841Medicare UPIN