MEDICARE: JJMV MEDSPA 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	246Z00000X	Other Specialist/Technologist

General Provider Information

NPI Number	:	1134089410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JJMV MEDSPA LLC

Provider Business Mailing Address
First Line	:	7 S MAIN ST STE B
Second Line	:
City	:	MARLBORO
State	:	NJ
Zip	:	07746-1578
Country	:	US
Telephone Number	:	732-358-9205
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 S MAIN ST STE B
Second Line	:
City	:	MARLBORO
State	:	NJ
Zip	:	07746-1578
Country	:	US
Telephone Number	:	732-358-9205
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EDMOND JOHN B MEJIAS -VENTURA
Credential	:
Telephone Number	:	732-358-9205

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	01/19/2026

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