Jay Clinic, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME34128 Issued in FL

Legal business name

JAY CLINIC, INC

Practice address

571 Avenue K SE
Winter Haven, FL 33880-4215

Phone

(863) 293-3909

Fax

(863) 293-1909

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Jitendra Mehta, MD

Title

Owner

Phone

(863) 293-3909

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1437369295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804215",
            "telephone_number": "863-293-3909",
            "fax_number": "863-293-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804215",
            "telephone_number": "863-293-3909",
            "fax_number": "863-293-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "JITENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-293-3909",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME34128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria T Jaramillo-Dolan, DPM
• Lisa M Jardine, MD
• Juan Rafael Jardines, ARNP
• Lauren Jarrell
• Paulene T Jasurek, RPH
• John Tanner Jay, DO
• Omar Nemours Jean-Baptiste
• Clyde Joseph Jean, RBT
• Breanna Jeanpierre
• Christopher Lance Jebailey, MD

• Specialist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.