Provider Demographics
NPI:1922011147
Name:JAY P KUMAR MD PA
Entity Type:Organization
Organization Name:JAY P KUMAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-597-6600
Mailing Address - Street 1:PO BOX 21727
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-1727
Mailing Address - Country:US
Mailing Address - Phone:727-823-2188
Mailing Address - Fax:727-823-9502
Practice Address - Street 1:10075 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613
Practice Address - Country:US
Practice Address - Phone:352-597-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DH2445OtherRAILROAD MEDICARE
FLK3259Medicare PIN