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General NPI Number Information
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NPI Number | 1649572942
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Entity Type | Organization
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Legal Business Name | JCR MEDICAL COORDINATION, INC
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 5400 S UNIVERSITY DR SUITE 401-410
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City | DAVIE
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State | FL
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Zip | 33328-5312
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Country | US
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Telephone | 954-835-5543
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Fax | 954-835-5549
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Provider Business Mailing Address
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Address Line | 5400 S UNIVERSITY DR SUITE 401-410
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City | DAVIE
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State | FL
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Zip | 33328-5312
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Country | US
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Telephone | 954-835-5543
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Fax | 954-835-5549
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JUAN ALEJANDRO PEREZ
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Credential |
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Telephone | 954-835-5543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | X008467-1
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License Number State | NY
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