MEDICARE: JAY ALLEN SPINKA PA-C

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	363AM0700X	Medical Physician Assistant	PA9101432	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	:	1548223134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY ALLEN SPINKA PA-C

Provider Business Mailing Address
First Line	:	6415 LAKE WORTH RD STE 302
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-2906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2290 10TH AVE N STE 401
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6609
Country	:	US
Telephone Number	:	561-284-8455
Fax Number	:

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	05/23/2023

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