Healthcare Provider Details

I. General information

NPI: 1487088282
Provider Name (Legal Business Name): JCMD MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 DR PHILLIPS BLVD SUITE 370
ORLANDO FL
32819-7216
US

IV. Provider business mailing address

7575 DR PHILLIPS BLVD SUITE 370
ORLANDO FL
32819-7216
US

V. Phone/Fax

Practice location:
  • Phone: 407-507-3837
  • Fax: 407-507-3841
Mailing address:
  • Phone: 407-507-3837
  • Fax: 407-507-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN CHRISTY CARROZZELLA II
Title or Position: OWNER / PHYSICIAN
Credential: MD
Phone: 813-659-2897