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General NPI Number Information
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NPI Number | 1255036299
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Entity Type | Organization
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Legal Business Name | JCJTAM, LLC.
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 16703 EARLY RISER AVE STE 287
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City | LAND O LAKES
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State | FL
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Zip | 34638-0192
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Country | US
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Telephone | 844-387-2476
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Fax | 844-387-2476
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Provider Business Mailing Address
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Address Line | 110 16TH ST STE 1400
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City | DENVER
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State | CO
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Zip | 80202-5275
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Country | US
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Telephone | 844-387-2476
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Fax | 844-387-2476
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | WILLIAM ALVAREZ
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Credential | CPCS, CPMSM
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Telephone | 800-931-6086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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