Provider Demographics
NPI:1780652602
Name:DENNIS, JAY J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:J
Last Name:DENNIS
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 1:20305 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1512
Mailing Address - Country:US
Mailing Address - Phone:305-932-2733
Mailing Address - Fax:305-932-2684
Practice Address - Street 1:20305 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1512
Practice Address - Country:US
Practice Address - Phone:305-932-2733
Practice Address - Fax:305-932-2684
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0077578207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46515OtherBLUE CROSS BLUE SHIELD
FL254182OtherAVMED
FLG90739Medicare UPIN
FL254182OtherAVMED