Organization
PRESTIGE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY JAY (OWNER)
(941) 362-4000
Entity
Organization
Contact information
Practice address
6924 PROFESSIONAL PKWY E, SUITE B, LAKEWOOD RANCH, FL 34240-8414
(941) 752-6002
(941) 752-6008
Mailing address
6924 PROFESSIONAL PKWY E, STE B, LAKEWOOD RANCH, FL 34240-8439
(941) 362-4000
(941) 362-4400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/24/2015
Last updated
07/19/2023
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