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General NPI Number Information
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NPI Number | 1629650841
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Entity Type | Organization
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Legal Business Name | JMG MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 1600 37TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-4863
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Country | US
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Telephone | 845-803-9267
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Fax | 772-202-7102
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Provider Business Mailing Address
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Address Line | 2160 58TH AVE # 240
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City | VERO BEACH
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State | FL
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Zip | 32966-4647
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Country | US
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Telephone | 845-803-9267
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Fax | 772-202-7102
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Authorized Official
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Title or Position | ORGANISER
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Name | JENNIFER M GERARD
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Credential | MD
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Telephone | 845-803-9267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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