Provider Demographics
NPI:1154725778
Name:JAIRAMDAS, KUMAR (DNP,ARNP,FNP-C,ENP-C)
Entity type:Individual
Prefix:DR
First Name:KUMAR
Middle Name:
Last Name:JAIRAMDAS
Suffix:
Gender:M
Credentials:DNP,ARNP,FNP-C,ENP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12909 CINNIMON PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-4504
Mailing Address - Country:US
Mailing Address - Phone:813-300-7813
Mailing Address - Fax:
Practice Address - Street 1:2020 TOWN CENTER BLVD
Practice Address - Street 2:STE B
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-677-8418
Practice Address - Fax:813-377-1686
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015206800Medicaid
FLY0S6UOtherBC/BS FLORIDA BLUE
FLP01667516OtherRR MEDICARE
FLP01667516OtherRR MEDICARE