MEDICARE: JAYAPRAKASH K KAMATH MD

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	207RG0100X	Gastroenterology Physician	ME36704	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

General Provider Information

NPI Number	:	1609831502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYAPRAKASH K KAMATH MD

Provider Business Mailing Address
First Line	:	5651 49TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-2105
Country	:	US
Telephone Number	:	727-443-4299
Fax Number	:	727-443-0255

Provider Business Practice Location Address
First Line	:	5651 49TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-2105
Country	:	US
Telephone Number	:	727-443-4299
Fax Number	:	727-443-0255

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	09/15/2021

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