DR. JAY SUNG PARK D.O. NPI 1639167877

NPI Information

  • NPI: 1639167877
  • Provider Name: DR. JAY SUNG PARK, D.O.
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1600 LAKELAND HILLS BLVD
    LAKELAND, FL
    ZIP 33805
  • Phone: (863) 680-7000

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NPI Details

DR. Jay Sung Park, D.O. is a diagnostic radiology radiology in Lakeland, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Jay Sung Park, D.O. NPI is 1639167877. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1600 LAKELAND HILLS BLVD
LAKELAND, FL
ZIP 33805-019
Phone: (863) 680-7000
Fax: (866) 264-8519

The NPI 1639167877 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/12/2005 and was last updated on 4/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology346214LOUISIANANo
22085R0202XRadiologyDiagnostic Radiology24.000017OHIONo
32085R0202XRadiologyDiagnostic RadiologyOS11094FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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