Provider Demographics
NPI:1942311014
Name:JAYANT C GAJERA, M.D., P.A.
Entity Type:Organization
Organization Name:JAYANT C GAJERA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:C
Authorized Official - Last Name:GAJERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-971-4400
Mailing Address - Street 1:14801 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2844
Mailing Address - Country:US
Mailing Address - Phone:813-971-4400
Mailing Address - Fax:813-971-1207
Practice Address - Street 1:14801 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2844
Practice Address - Country:US
Practice Address - Phone:813-971-4400
Practice Address - Fax:813-971-1207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K6996Medicare ID - Type Unspecified