Healthcare Provider Details

I. General information

NPI: 1912284779
Provider Name (Legal Business Name): JMAX SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 W 14TH ST
JACKSONVILLE FL
32209-4603
US

IV. Provider business mailing address

2213 W 14TH ST
JACKSONVILLE FL
32209-4603
US

V. Phone/Fax

Practice location:
  • Phone: 904-210-6651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. SERINA MAXWELL
Title or Position: OWNER
Credential:
Phone: 904-210-6651