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General NPI Number Information
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NPI Number | 1578055620
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Entity Type | Organization
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Legal Business Name | J MICHEL LLC
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 06/05/2018
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Provider Practice Location Address
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Address Line | 5645 PINEY RIDGE DR
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City | ORLANDO
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State | FL
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Zip | 32808-4874
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Country | US
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Telephone | 407-580-5036
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 681813
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City | ORLANDO
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State | FL
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Zip | 32868-1813
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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 | OWNER/OPERATOR
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Name | JUDITH MICHEL-JACKSON
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Credential |
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Telephone | 407-267-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 234799
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 234799
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License Number State | FL
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