Jaffray Podiatry Center PL LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

P02662 Issued in FL

Legal business name

JAFFRAY PODIATRY CENTER PL LLC

Practice address

18940 Dale Mabry Hwy N
Suite 101
Lutz, FL 33548-4906

Phone

(813) 949-7555

Fax

(813) 949-7554

NPI assigned

Jun 15, 2007

Last updated

Sep 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin A Jaffray, DPM

Title

Owner

Phone

(813) 949-7555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1962607416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340683",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336940683",
            "telephone_number": "813-949-7555",
            "fax_number": "813-949-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18940 DALE MABRY HWY N",
            "address_2": "SUITE 101",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484906",
            "telephone_number": "813-949-7555",
            "fax_number": "813-949-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAFFRAY PODIATRY CENTER PL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "JAFFRAY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-949-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P02662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390467900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Lutz, FL
• Providers in Lutz, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.