Organization
JAFFRAY PODIATRY CENTER PL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN A JAFFRAY DPM (OWNER)
(813) 949-7555
Entity
Organization
Contact information
Practice address
18940 DALE MABRY HWY N, SUITE 101, LUTZ, FL 33548-4906
(813) 949-7555
(813) 949-7554
Mailing address
PO BOX 340683, TAMPA, FL 33694-0683
(813) 949-7555
(813) 949-7554
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P02662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390467900
—
FL
Enumeration date
06/15/2007
Last updated
09/29/2010
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