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General NPI Number Information
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NPI Number | 1114626934
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Entity Type | Organization
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Legal Business Name | JLJ MEDICAL LLC
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | GO-6B AVE ROBERTO SANCHEZ VILELLA URB. COUNTRY CLUB
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City | CAROLINA
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State | PR
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Zip | 00982-0098
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Country | US
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Telephone | 623-810-4052
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE PLATANILLO 1908 URB SANTA MARIA
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. JEREMIAH JEFFERS
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Credential | MD
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Telephone | 623-810-4052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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