Healthcare Provider Details

I. General information

NPI: 1386733822
Provider Name (Legal Business Name): JAS MEDICAL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 MIRAMAR PKWY SUITE 104
MIRAMAR FL
33023-3970
US

IV. Provider business mailing address

1981 SW 133RD AVE
MIRAMAR FL
33027-3457
US

V. Phone/Fax

Practice location:
  • Phone: 954-965-6001
  • Fax: 954-965-6009
Mailing address:
  • Phone: 954-965-6001
  • Fax: 954-965-6009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SULTAN S AHMED
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-965-6001