Provider Demographics
NPI:1871855049
Name:KUMAR, JAYA BADHWAR (MD)
Entity Type:Individual
Prefix:
First Name:JAYA
Middle Name:BADHWAR
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAYA
Other - Middle Name:
Other - Last Name:BADHWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:95 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1101
Mailing Address - Country:US
Mailing Address - Phone:407-849-9621
Mailing Address - Fax:904-996-1446
Practice Address - Street 1:95 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1101
Practice Address - Country:US
Practice Address - Phone:407-849-9621
Practice Address - Fax:407-420-4056
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134614207WX0107X, 207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023791300Medicaid