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General NPI Number Information
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NPI Number | 1407458136
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Entity Type | Organization
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Legal Business Name | JETDOC, INC.
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 7787 ARBOR CREST WAY
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33412-2465
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Country | US
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Telephone | 561-389-1380
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Fax |
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Provider Business Mailing Address
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Address Line | 7787 ARBOR CREST WAY
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33412-2465
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Country | US
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Telephone | 561-389-1380
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Fax |
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | ISABELLE DIECKMANN
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Credential |
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Telephone | 833-453-8362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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