Individual
JAY RALEIGH HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
8036 S TAMIAMI TRAIL, VENICE, FL 34293-5113
(941) 244-4300
(941) 244-4380
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002111
CT
363AM0700X
Medical Physician Assistant
Primary
PA9116008
FL
Other
Enumeration date
05/02/2007
Last updated
08/23/2024
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