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Individual

DR. JAYA N. SURUJDYAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS14043
FL
390200000X
Student in an Organized Health Care Education/Training Program
UO3552
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017877600
FL
01
OS14043
MEDICAL LICENSE
FL
Enumeration date
05/23/2013
Last updated
11/17/2016
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