MEDICARE: JAYDA LEIGH CORRELL

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	156F00000X	Technician/Technologist		FL

General Provider Information

NPI Number	:	1457215840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYDA LEIGH CORRELL

Provider Business Mailing Address
First Line	:	3200 N ALAFAYA TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32826-3109
Country	:	US
Telephone Number	:	863-602-1797
Fax Number	:

Provider Business Practice Location Address
First Line	:	7635 ASHLEY PARK CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6195
Country	:	US
Telephone Number	:	321-972-4265
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ JAYDA LEIGH CORRELL ” Practice Location

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