Healthcare Provider Details

I. General information

NPI: 1376285924
Provider Name (Legal Business Name): JEWELS CAPITAL PREVENTATIVE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 09/06/2023
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8511 BULL HEADLEY RD STE 400
TALLAHASSEE FL
32312-5132
US

IV. Provider business mailing address

2509 ARVAH BRANCH BLVD
TALLAHASSEE FL
32309-9106
US

V. Phone/Fax

Practice location:
  • Phone: 850-779-0719
  • Fax: 786-299-0310
Mailing address:
  • Phone: 786-348-1335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIA TJANDERA
Title or Position: OWNER
Credential: APRN
Phone: 786-348-1335