Healthcare Provider Details

I. General information

NPI: 1992323497
Provider Name (Legal Business Name): JMF WELLNESS AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6190 SW 116TH ST
PINECREST FL
33156-4957
US

IV. Provider business mailing address

6190 SW 116TH ST
PINECREST FL
33156-4957
US

V. Phone/Fax

Practice location:
  • Phone: 786-205-4997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JANELLE MARIE FLEITES
Title or Position: OWNER
Credential: PT
Phone: 786-205-4997