Redan, Jay A

Redan, Jay A is an individual health care provider with primary practice located at 400 Celebration Pl Suite A-140, Celebration FL 34747-4970. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Redan, Jay A can be contacted via phone (407) 303-4602.

Contact Information

Primary practice address
400 Celebration Pl Suite A-140 Celebration FL 34747-4970
Fax: (407) 303-4603
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME89458 Florida

Profile Details

NPI number 1376562553
LBN Legal business name Redan, Jay A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Apr 30th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376562553 NPPES
Florida MEDICAID 269094200
Florida Other 37613
Florida Other P00149683

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