MEDICARE: J&K MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1043027790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&K MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	9759 SAN JOSE BLVD STE 5
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5418
Country	:	US
Telephone Number	:	786-608-7808
Fax Number	:

Provider Business Practice Location Address
First Line	:	9759 SAN JOSE BLVD STE 5
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5418
Country	:	US
Telephone Number	:	786-608-7808
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YASMANY MARRERO
Credential	:
Telephone Number	:	786-608-7808

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/03/2025

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