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General NPI Number Information
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NPI Number | 1467051896
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Entity Type | Organization
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Legal Business Name | JERMAINE CAMPBELL DO, LLC
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 2701 N COURSE DR APT 125
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3030
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Country | US
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Telephone | 754-264-6061
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Fax |
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Provider Business Mailing Address
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Address Line | 12491 BAYWIND CT
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City | BOCA RATON
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State | FL
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Zip | 33428-4704
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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 | CEO
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Name | DR. JERMAINE CAMPBELL
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Credential | DO
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Telephone | 754-264-6061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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