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General NPI Number Information
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NPI Number | 1154018869
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Entity Type | Organization
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Legal Business Name | JKMENONLLC
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 7636 NE 4TH CT
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City | MIAMI
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State | FL
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Zip | 33138-5285
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Country | US
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Telephone | 904-315-4955
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 NE 188TH ST APT 812
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City | AVENTURA
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State | FL
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Zip | 33180-3377
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Country | US
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Telephone | 954-240-8725
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | DR. JYOTSNA KOCHIYIL
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Credential | MD
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Telephone | 954-240-8725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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