Healthcare Provider Details

I. General information

NPI: 1356262729
Provider Name (Legal Business Name): JCR HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15405 COLLIER BLVD STE 11
NAPLES FL
34119-7879
US

IV. Provider business mailing address

15405 COLLIER BLVD STE 11
NAPLES FL
34119-7879
US

V. Phone/Fax

Practice location:
  • Phone: 555-555-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN RADFORD
Title or Position: CO-OWNER
Credential: MD
Phone: 555-555-5555