Individual
DR. JAY A REDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 CELEBRATION PL, SUITE A-140, CELEBRATION, FL 34747-4970
(407) 303-4602
(407) 303-4603
Mailing address
400 CELEBRATION PL, SUITE A-140, CELEBRATION, FL 34747-4970
(407) 303-4602
(407) 303-4603
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME89458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269094200
—
FL
01
—
37613
BCBS
FL
01
—
P00149683
RAILROAD MEDICARE
—
Enumeration date
07/19/2006
Last updated
04/30/2012
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