Healthcare Provider Details

I. General information

NPI: 1538401583
Provider Name (Legal Business Name): JENNIFER LYNN MURDOCK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2013
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 41ST ST STE 406
MIAMI BEACH FL
33140-3517
US

IV. Provider business mailing address

2020 N BAYSHORE DR APT 1705
MIAMI FL
33137-5164
US

V. Phone/Fax

Practice location:
  • Phone: 305-315-5577
  • Fax: 832-324-6986
Mailing address:
  • Phone: 305-315-3377
  • Fax: 832-324-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberME153933
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberS3027
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME153933
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: