Provider Demographics
NPI:1821045642
Name:MAIZES, JAY S (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:S
Last Name:MAIZES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5401 S CONGRESS AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6637
Mailing Address - Country:US
Mailing Address - Phone:561-967-4118
Mailing Address - Fax:561-967-3463
Practice Address - Street 1:5401 S CONGRESS AVE STE 204
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6637
Practice Address - Country:US
Practice Address - Phone:561-967-4118
Practice Address - Fax:561-967-3463
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME78963207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262868600Medicaid
FLKW569OtherMEDICARE