| Jay Medical Pllc | |
|
406 5th Ave Indialantic FL 32903-4280 | |
| (321) 473-8974 | |
| (321) 473-8976 |
| Full Name | Jay Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 406 5th Ave, Indialantic, Florida |
| Authorized Official Name and Position | Jayadevan Kundumadathil (OWNER) |
| Authorized Official Contact | 3214738974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay Medical Pllc 406 5th Ave Indialantic FL 32903-4280 Ph: (321) 473-8974 | Jay Medical Pllc 406 5th Ave Indialantic FL 32903-4280 Ph: (321) 473-8974 |
| NPI Number | 1912210055 |
|---|---|
| Provider Enumeration Date | 07/19/2010 |
| Last Update Date | 08/06/2010 |
| Medicare PECOS PAC ID | 8022141233 |
|---|---|
| Medicare Enrollment ID | O20100809000219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912210055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME78547 (Florida) | Primary |
| Provider Name | Janet A Anciro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578538278 PECOS PAC ID: 5597898668 Enrollment ID: I20100727000668 |
| Provider Name | Jayadeuan Kundumadathil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912968918 PECOS PAC ID: 6204969413 Enrollment ID: I20100809000232 |
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