Organization
CANADY & JAGDEO PHYSICIAN ASSOCIATES P L
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME CANADY (PRESIDENT)
(412) 508-4831
Entity
Organization
Contact information
Practice address
1645 LAKELAND HILLS BLVD, SUITE 4, LAKELAND, FL 33805-3025
(412) 508-4831
Mailing address
1645 LAKELAND HILLS BLVD, SUITE 4, LAKELAND, FL 33805-3025
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME102632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101963446002
—
PA
Enumeration date
10/02/2008
Last updated
10/09/2008
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