Healthcare Provider Details

I. General information

NPI: 1740251560
Provider Name (Legal Business Name): JONATHAN BYRON MAY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5748 54 AVE NORTH
KENNETH CITY FL
33709
US

IV. Provider business mailing address

5748 54 AVE NORTH
KENNETH CITY FL
33709
US

V. Phone/Fax

Practice location:
  • Phone: 727-343-9400
  • Fax: 727-209-0399
Mailing address:
  • Phone: 727-343-9400
  • Fax: 727-209-0399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO1302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: