Healthcare Provider Details
I. General information
NPI: 1649620733
Provider Name (Legal Business Name): JNM SENIOR SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2016
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5178 DR PHILLIPS BLVD
ORLANDO FL
32819-3312
US
IV. Provider business mailing address
5178 DR PHILLIPS BLVD
ORLANDO FL
32819-3312
US
V. Phone/Fax
- Phone: 407-232-7155
- Fax:
- Phone: 407-232-7155
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | 299994419 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
JAMES
PASQUINELLI
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 407-232-7155