Healthcare Provider Details

I. General information

NPI: 1699484402
Provider Name (Legal Business Name): JM STYLES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13085 SW 1ST LN STE 60
NEWBERRY FL
32669-3747
US

IV. Provider business mailing address

PO BOX 374
WILLISTON FL
32696-0374
US

V. Phone/Fax

Practice location:
  • Phone: 719-357-0094
  • Fax:
Mailing address:
  • Phone: 719-357-0094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE DANITA MORRIS
Title or Position: OWNER
Credential:
Phone: 719-357-0094