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General NPI Number Information
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NPI Number | 1093539538
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Entity Type | Organization
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Legal Business Name | BERAKAH JIREH INSURANCE LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 15680 SW 88TH ST STE 201
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City | MIAMI
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State | FL
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Zip | 33196-1160
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Country | US
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Telephone | 305-338-9828
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Fax | 561-258-0582
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Provider Business Mailing Address
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Address Line | 17626 SW 10TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-4845
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Country | US
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Telephone | 305-338-9828
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Fax | 561-258-0582
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MR. DARRELL JOHNSON
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Credential |
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Telephone | 561-356-6313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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