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Individual

JAY S WALLSHEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5057 SOUTH CONGRESS AVE, STE 403, ATLANTIS, FL 33461-4723
(561) 433-5200
(561) 433-5206
Mailing address
5057 SOUTH CONGRESS AVE, STE 403, ATLANTIS, FL 33461-4723
(561) 433-5200
(561) 433-5206

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
92488
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00212814
MEDICARE RR
FL
Enumeration date
06/08/2005
Last updated
02/06/2008
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