Jae Won Lim Layug
Nurse Practitioner, Acute Care in Davenport, FL. Individual provider (NPI-1).
NPI number1104516491
StatusActive
Last updated in NPPESOct 10, 2023
Details
- NPI
- 1104516491
- Entity type
- Individual (NPI-1)
- Name
- Jae Won Lim Layug
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 10, 2023
- Certification date
- Oct 10, 2023
- Last updated
- Oct 10, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 11026214 | FL | Yes |
| 363LC0200X | Nurse Practitioner, Critical Care Medicine | 11026214 | FL |
Practice location
405 Lionel WayDavenport, FL 33837-7811
Phone 863-353-1390 · Fax 863-438-4880
Mailing address
405 Lionel WayDavenport, FL 33837-7811
Phone 863-353-1390 · Fax 863-438-4880
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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