Individual
JAY J MAMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME34678
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038872600
—
FL
01
—
30203
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/09/2006
Last updated
03/30/2021
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