Healthcare Provider Details
I. General information
NPI: 1316767916
Provider Name (Legal Business Name): JLM INVEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2024
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8410 W FLAGLER ST STE 210
MIAMI FL
33144-2000
US
IV. Provider business mailing address
8410 W FLAGLER ST STE 210
MIAMI FL
33144-2000
US
V. Phone/Fax
- Phone: 305-701-1085
- Fax: 305-701-1086
- Phone: 305-701-1085
- Fax: 305-701-1086
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0808X |
| Taxonomy | Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
LUIS
MANUEL
GOMEZ HERNANDEZ
Title or Position: NURSE PRACTITIONER IN CHARGE
Credential: APRN
Phone: 786-578-3797