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General NPI Number Information
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NPI Number | 1396913380
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Entity Type | Organization
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Legal Business Name | JAY ANANTHAN-NAIR OD P A
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 1308 E NORMANDY BLVD STE D
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City | DELTONA
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State | FL
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Zip | 32725-8448
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Country | US
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Telephone | 386-668-3812
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 E NORMANDY BLVD STE D
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City | DELTONA
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State | FL
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Zip | 32725-8448
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Country | US
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Telephone | 386-668-3812
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAYAKUMAR ANANTHAN-NAIR
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Credential | O.D., PHD
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Telephone | 386-860-3812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | FL2940
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License Number State | FL
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