Individual
JAYDEV H AVASHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40107 HIGHWAY 27 STE 200, DAVENPORT, FL 33837-5901
(863) 421-9705
(863) 421-9779
Mailing address
4371 VERONICA S SHOEMAKER BLVD, ATTN: CREDENTIALING DEPT, FORT MYERS, FL 33916-2216
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME57515
FL
207RX0202X
Medical Oncology Physician
Primary
ME57515
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063384400
—
FL
01
—
10719
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/17/2005
Last updated
06/11/2020
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