Healthcare Provider Details

I. General information

NPI: 1134790215
Provider Name (Legal Business Name): JOHN RICHARD JAYMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 POINTE WEST DR STE 101
VERO BEACH FL
32966-1308
US

IV. Provider business mailing address

3835 11TH SQ UNIT 4102
VERO BEACH FL
32960-5759
US

V. Phone/Fax

Practice location:
  • Phone: 772-564-7828
  • Fax:
Mailing address:
  • Phone: 443-797-2710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number178432
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: