MEDICARE: PATRICIA ANN JAY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	ARNP1397802	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP1397802	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316044472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ANN JAY ARNP

Provider Business Mailing Address
First Line	:	15604 EASTBOURN DR
Second Line	:
City	:	ODESSA
State	:	FL
Zip	:	33556-2850
Country	:	US
Telephone Number	:	813-920-3664
Fax Number	:	813-920-3491

Provider Business Practice Location Address
First Line	:	7820 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-3852
Country	:	US
Telephone Number	:	813-935-6060
Fax Number	:	813-933-8096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	12/29/2008

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Directions to “ PATRICIA ANN JAY ARNP” Practice Location

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