Healthcare Provider Details
I. General information
NPI: 1275453250
Provider Name (Legal Business Name): JCM RADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 SW 75TH AVE
MIAMI FL
33155-2805
US
IV. Provider business mailing address
21272 ESCONDIDO WAY S
BOCA RATON FL
33433-2523
US
V. Phone/Fax
- Phone: 561-926-0239
- Fax:
- Phone: 561-926-0239
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
PUCHFERRAN
Title or Position: MANAGER
Credential: MD
Phone: 561-926-0239