Healthcare Provider Details

I. General information

NPI: 1629982111
Provider Name (Legal Business Name): JEWEL SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18821 NW 23RD CT
MIAMI GARDENS FL
33056-3238
US

IV. Provider business mailing address

1728 NE MIAMI GARDENS DR # 1153
NORTH MIAMI BEACH FL
33179-5301
US

V. Phone/Fax

Practice location:
  • Phone: 786-406-2562
  • Fax:
Mailing address:
  • Phone: 786-406-2562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name: QUITA FREEMAN
Title or Position: CEO
Credential:
Phone: 786-406-2562