Healthcare Provider Details

I. General information

NPI: 1386576916
Provider Name (Legal Business Name): INFECTIOUS DISEASE MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 BOCA DEL MAR DR
BOCA RATON FL
33433-5517
US

IV. Provider business mailing address

701 N FEDERAL HWY STE 201
HALLANDALE BEACH FL
33009-2450
US

V. Phone/Fax

Practice location:
  • Phone: 954-482-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC JARQUIN
Title or Position: FINANCIAL CONTROLLER
Credential:
Phone: 954-651-8332