Provider Demographics
NPI:1619930641
Name:ADLER, JAY B (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:B
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5431 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4639
Mailing Address - Country:US
Mailing Address - Phone:954-344-2522
Mailing Address - Fax:954-344-9189
Practice Address - Street 1:1776 N PINE ISLAND RD
Practice Address - Street 2:SUITE 210
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5233
Practice Address - Country:US
Practice Address - Phone:954-792-2220
Practice Address - Fax:954-792-4443
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME54338207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E83798Medicare UPIN
FL12121ZMedicare PIN