Healthcare Provider Details

I. General information

NPI: 1427811470
Provider Name (Legal Business Name): JENNIFER MURDOCK MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12750 NW 17TH ST UNIT 226
MIAMI FL
33182-1423
US

IV. Provider business mailing address

12750 NW 17TH ST UNIT 226
MIAMI FL
33182-1423
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER MURDOCK
Title or Position: OWNER/ MEMBER
Credential: MD
Phone: 305-315-5577