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General NPI Number Information
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NPI Number | 1588396105
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Entity Type | Organization
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Legal Business Name | JPS INTERNATIONAL SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 2916 MAGNOLIA BLOSSOM CIR
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City | CLERMONT
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State | FL
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Zip | 34711-7522
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Country | US
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Telephone | 352-678-9472
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 MAGNOLIA BLOSSOM CIR
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City | CLERMONT
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State | FL
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Zip | 34711-7522
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Country | US
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Telephone | 352-678-9472
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | MICHAEL JAY PETERS
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Credential | PHLEBOTOMIST
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Telephone | 352-678-9472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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