Healthcare Provider Details

I. General information

NPI: 1679312862
Provider Name (Legal Business Name): JFI SPORTS MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 PALMS WEST DR STE 202
LOXAHATCHEE FL
33470-9217
US

IV. Provider business mailing address

12955 PALMS WEST DR STE 202
LOXAHATCHEE FL
33470-9217
US

V. Phone/Fax

Practice location:
  • Phone: 561-894-9966
  • Fax: 561-208-3824
Mailing address:
  • Phone: 561-894-9966
  • Fax: 561-208-3824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN E COLEMAN
Title or Position: OWNER
Credential: MD
Phone: 561-886-8667