Individual
DR. JAYALAKSHMI PADMANABHAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D., P.A.
Contact information
Practice address
108 KINGSLEY AVE, ORANGE PARK, FL 32073-5685
(904) 264-0000
(904) 264-1828
Mailing address
108 KINGSLEY AVE, ORANGE PARK, FL 32073-5685
(904) 264-0000
(904) 264-1828
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME19491
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1504223
UNITED MINE WORKER
FL
01
—
6895400
BLACK LUNG
FL
Enumeration date
08/09/2005
Last updated
07/08/2007
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