Canady & Jagdeo Physician Associates P L

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME102632 Issued in FL

Legal business name

CANADY & JAGDEO PHYSICIAN ASSOCIATES P L

Practice address

1645 Lakeland Hills Blvd
Suite 4
Lakeland, FL 33805-3025

Phone

(412) 508-4831

NPI assigned

Oct 2, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerome Canady

Title

President

Phone

(412) 508-4831

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Canaday and Jagedo Physician Associates PL2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Canaday and Jagedo Physician Associates PL

  • Surgery Physician
  • Palatka, FL
  • NPI 1780814988
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1295986891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LAKELAND HILLS BLVD",
            "address_2": "SUITE 4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LAKELAND HILLS BLVD",
            "address_2": "SUITE 4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053025",
            "telephone_number": "412-508-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANADY & JAGDEO PHYSICIAN ASSOCIATES P L",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "CANADY",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-508-4831"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME102632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101963446002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kala Marie Camper, APRN, PMHNP-BC
• Armando Campos
• Crystal Marie Campus
• Lysmar Karina Cancho I
• Rodolfo Rene Candia, R.PH
• Cannacare Medical Group LLC
• Sara Cannefax
• Walter Wayne Cannefax

• Surgery Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.