Provider Demographics
NPI:1568910628
Name:S & J PA
Entity Type:Organization
Organization Name:S & J PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:727-845-1736
Mailing Address - Street 1:5307 MAIN ST
Mailing Address - Street 2:STE 102
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-2536
Mailing Address - Country:US
Mailing Address - Phone:727-845-1736
Mailing Address - Fax:727-849-0759
Practice Address - Street 1:5307 MAIN ST
Practice Address - Street 2:STE 102
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-2536
Practice Address - Country:US
Practice Address - Phone:727-845-1736
Practice Address - Fax:727-849-0759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty