Olsson, Jay Edward

Olsson, Jay Edward is an sole proprietor health care provider with primary practice located at 401 N Wickham Rd Suite S, Melbourne FL 32935-8659. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Olsson, Jay Edward can be contacted via phone (321) 242-9031.

Contact Information

Primary practice address
401 N Wickham Rd Suite S Melbourne FL 32935-8659
Phone: (321) 242-9031
Fax: (321) 242-9035
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X OS0004087 Florida
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X OS4087 Florida

Profile Details

NPI number 1144264904
LBN Legal business name Olsson, Jay Edward
Credentials DO PROF ASSOCIATIONN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2006
Last updated Sep 16th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144264904 NPPES
Florida MEDICAID 045794900

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