Provider Demographics
NPI:1740544220
Name:JAY A STREIMER PA
Entity type:Organization
Organization Name:JAY A STREIMER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:STREIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-476-0200
Mailing Address - Street 1:4400 SW 107TH WAY
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2164
Mailing Address - Country:US
Mailing Address - Phone:954-476-0200
Mailing Address - Fax:954-476-0200
Practice Address - Street 1:4400 SW 107TH WAY
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2164
Practice Address - Country:US
Practice Address - Phone:954-476-0200
Practice Address - Fax:954-476-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686048696OtherMED WAIVER