Individual
JAY K SAMAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4435 US HIGHWAY 98 N, LAKELAND, FL 33809
(863) 858-8000
Mailing address
4435 US HIGHWAY 98 N, LAKELAND, FL 33809-0402
(863) 858-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-08068
NC
363A00000X
Physician Assistant
Primary
PA9111308
FL
Other
Enumeration date
06/28/2018
Last updated
10/04/2018
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