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General NPI Number Information
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NPI Number | 1326163643
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Entity Type | Organization
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Legal Business Name | JMG SERVICES INC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6717 NW 27TH ST
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City | MARGATE
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State | FL
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Zip | 33063-2035
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Country | US
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Telephone | 954-984-5834
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Fax |
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Provider Business Mailing Address
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Address Line | 6717 NW 27TH ST
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City | MARGATE
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State | FL
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Zip | 33063-2035
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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 | PRESIDENT
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Name | MELISSA GONZALEZ
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Credential |
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Telephone | 954-984-5834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA39209
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License Number State | FL
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