Provider Demographics
NPI:1730433574
Name:LOKAY, JAN GAMBLIN
Entity type:Individual
Prefix:MS
First Name:JAN
Middle Name:GAMBLIN
Last Name:LOKAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:GERALDINE
Other - Last Name:LOKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1407 DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-6411
Mailing Address - Country:US
Mailing Address - Phone:321-452-0800
Mailing Address - Fax:321-394-0385
Practice Address - Street 1:1407 DIXON BLVD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-6411
Practice Address - Country:US
Practice Address - Phone:321-452-0800
Practice Address - Fax:321-394-0385
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker