Provider Demographics
NPI:1811051774
Name:TEMKIN, JAY LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:LEONARD
Last Name:TEMKIN
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 1:5793 LAGO VILLAGGIO WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5741
Mailing Address - Country:US
Mailing Address - Phone:239-274-0018
Mailing Address - Fax:
Practice Address - Street 1:5793 LAGO VILLAGGIO WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-5741
Practice Address - Country:US
Practice Address - Phone:239-274-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME842292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11035OtherBLUE CROSS BLUE SHIELD
FLG51064Medicare UPIN