Individual
DR. JAY P COLELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3725 11TH CR, VERO BEACH, FL 32960-4804
(772) 562-0163
Mailing address
3725 11TH CR, VERO BEACH, FL 32960-4804
(772) 562-0163
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME54269
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME54269
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08619
BLUE CROSS/BLUE SHIELD
FL
05
—
55797800
—
FL
Enumeration date
06/24/2005
Last updated
09/06/2012
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