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General NPI Number Information
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NPI Number | 1720485261
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Entity Type | Organization
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Legal Business Name | BJW MED SERVICE LLC
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Dates
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Enumeration Date | 11/27/2014
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Last Update Date | 11/27/2014
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Provider Practice Location Address
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Address Line | 13830 MORNING FROST DR
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City | ORLANDO
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State | FL
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Zip | 32828-7479
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Country | US
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Telephone | 407-415-8874
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Fax | 321-804-5476
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Provider Business Mailing Address
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Address Line | 13830 MORNING FROST DR
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City | ORLANDO
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State | FL
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Zip | 32828-7479
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Country | US
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Telephone | 407-415-8874
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Fax | 321-804-5476
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. MERLYN SONIA SALMON
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Credential | ARNP
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Telephone | 407-415-8874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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