Provider Demographics
NPI:1134175938
Name:SINGH, JASJOT PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JASJOT
Middle Name:PAUL
Last Name:SINGH
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 1:3319 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1354
Mailing Address - Country:US
Mailing Address - Phone:954-835-5495
Mailing Address - Fax:
Practice Address - Street 1:4478 WESTON RD
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-3195
Practice Address - Country:US
Practice Address - Phone:954-406-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79089207R00000X
TN035972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3781285OtherMEDICARE
TN3781285OtherMEDICARE