Healthcare Provider Details

I. General information

NPI: 1295828887
Provider Name (Legal Business Name): JMJ FAMILY PRACTICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N. JOHN YOUNG PKWY
KISSIMMEE FL
34741
US

IV. Provider business mailing address

300 N JOHN YOUNG PKWY
KISSIMMEE FL
34741-4902
US

V. Phone/Fax

Practice location:
  • Phone: 407-935-9012
  • Fax: 407-935-9108
Mailing address:
  • Phone: 407-935-9012
  • Fax: 407-935-9108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE RAMON FERNANDEZ
Title or Position: MEDICAL DOCTOR / OWNER
Credential:
Phone: 407-935-9012