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General NPI Number Information
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NPI Number | 1053701565
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Entity Type | Organization
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Legal Business Name | JM FAMILY ENTERPRISES, INC.
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 9985 PRITCHARD RD
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City | JACKSONVILLE
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State | FL
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Zip | 32219-2894
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Country | US
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Telephone | 904-378-4652
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Fax | 904-378-4568
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Provider Business Mailing Address
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Address Line | 111 JIM MORAN BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1701
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Country | US
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Telephone | 954-429-2418
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Fax | 954-429-2148
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Authorized Official
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Title or Position | GROUP VICE PRESIDENT
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Name | ED BROWN
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Credential |
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Telephone | 954-596-3976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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