Healthcare Provider Details

I. General information

NPI: 1437989340
Provider Name (Legal Business Name): JPMEDICAL & WELLNESS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6215 N UNIVERSITY DR
TAMARAC FL
33321-4022
US

IV. Provider business mailing address

6215 N UNIVERSITY DR
TAMARAC FL
33321-4022
US

V. Phone/Fax

Practice location:
  • Phone: 954-330-2115
  • Fax: 954-301-8259
Mailing address:
  • Phone: 954-330-2115
  • Fax: 954-301-8259

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: MARIA JAIMES
Title or Position: OWNER
Credential: MD
Phone: 954-330-2115