MEDICARE: JAYTEE CLINICIANS

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1508520883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAYTEE CLINICIANS

Provider Business Mailing Address
First Line	:	4000 N STATE ROAD 7 STE 409D
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-4882
Country	:	US
Telephone Number	:	954-534-4069
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 N STATE ROAD 7 STE 409D
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-4882
Country	:	US
Telephone Number	:	954-534-4069
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANET TAIT-ROPER
Credential	:
Telephone Number	:	954-534-4069

Provider Enumeration Date	:	10/23/2021
Last Update Date	:	01/27/2023

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Directions to “JAYTEE CLINICIANS ” Practice Location

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