MEDICARE: JAYSON A LORD M.D.

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	2085R0202X	Diagnostic Radiology Physician	ME72864	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	:	1285625046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYSON A LORD M.D.

Provider Business Mailing Address
First Line	:	314 N LAKE DR
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-2960
Country	:	US
Telephone Number	:	813-322-3800
Fax Number	:	813-322-3837

Provider Business Practice Location Address
First Line	:	314 N LAKE DR
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-2960
Country	:	US
Telephone Number	:	813-322-3800
Fax Number	:	813-322-3837

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	12/23/2025

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