Older, Jay Justin
Older, Jay Justin is an individual health care provider with primary practice located at 4444 E Fletcher Ave Ste D , Tampa FL 33613-4905. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery is his primary health care specialty. Older, Jay Justin can be contacted via phone (813) 971-3846.Contact Information
Primary practice address
4444 E Fletcher Ave Ste D
Tampa FL 33613-4905
Phone: (813) 971-3846
Fax: (813) 977-2611
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME21356 | Florida |
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery | 207WX0200X | ME21356 | Florida |
Profile Details
NPI number | 1477531432 |
---|---|
LBN Legal business name | Older, Jay Justin |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 9th, 2006 |
Last updated | Sep 7th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1477531432 | NPPES |
Florida | Other | ME0021356 | STATE LICENSE # |
Florida | Other | 1036672011 | STATE LICENSE # |
Florida | Other | 29789 | STATE LICENSE # |
Florida | Other | 181907220 | STATE LICENSE # |
Florida | Other | 624179 | STATE LICENSE # |
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