Healthcare Provider Details

I. General information

NPI: 1437444023
Provider Name (Legal Business Name): FLORIDA JOINT CARE INSTITUTE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 LITTLE RD
TRINITY FL
34655-4410
US

IV. Provider business mailing address

2165 LITTLE RD
TRINITY FL
34655-4410
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-6637
  • Fax: 727-375-5044
Mailing address:
  • Phone: 727-372-6637
  • Fax: 727-375-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER LYNN COOK
Title or Position: PARTNER
Credential: MD
Phone: 727-372-6637