Healthcare Provider Details

I. General information

NPI: 1528084639
Provider Name (Legal Business Name): JMS MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5545 SW 8TH ST SUITE 104
CORAL GABLES FL
33134-2274
US

IV. Provider business mailing address

5545 SW 8TH ST SUITE 104
CORAL GABLES FL
33134-2274
US

V. Phone/Fax

Practice location:
  • Phone: 305-267-4970
  • Fax: 305-267-4976
Mailing address:
  • Phone: 305-267-4970
  • Fax: 305-267-4976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MIGUEL FRANCISCO HERNANDEZ
Title or Position: MANAGER
Credential: M.D.
Phone: 305-267-4970