Individual
JAY PETER LAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1505 53RD AVE E, BRADENTON, FL 34203-4249
(941) 357-7950
(941) 840-1003
Mailing address
1505 53RD AVE E, BRADENTON, FL 34203-4249
(941) 357-7950
(941) 840-1003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
722087
CA
363L00000X
Nurse Practitioner
811582
NV
363L00000X
Nurse Practitioner
95008875
CA
363L00000X
Nurse Practitioner
APRN11014944
FL
363LA2200X
Adult Health Nurse Practitioner
APRN11014944
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11014944
FL
Other
Enumeration date
05/01/2018
Last updated
01/25/2023
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