Healthcare Provider Details

I. General information

NPI: 1326514167
Provider Name (Legal Business Name): JAMES J JENNINGS MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2018
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11921 SOUTH DIXIE HWY STE. 201
PINECREST FL
33156
US

IV. Provider business mailing address

11921 SOUTH DIXIE HWY STE. 201
PINECREST FL
33156
US

V. Phone/Fax

Practice location:
  • Phone: 786-868-0503
  • Fax: 786-524-0956
Mailing address:
  • Phone: 786-868-0503
  • Fax: 786-524-0956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES JOSEPH JENNINGS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-803-1519