MEDICARE: JAS MEDICAL MANAGEMENT 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	261Q00000X	Clinic/Center
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32644	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1386733822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAS MEDICAL MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	1981 SW 133RD AVE
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-3457
Country	:	US
Telephone Number	:	954-965-6001
Fax Number	:	954-965-6009

Provider Business Practice Location Address
First Line	:	6151 MIRAMAR PKWY
Second Line	:	SUITE 104
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3970
Country	:	US
Telephone Number	:	954-965-6001
Fax Number	:	954-965-6009

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SULTAN S AHMED
Credential	:	M.D.
Telephone Number	:	954-965-6001

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	03/11/2025

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Directions to “JAS MEDICAL MANAGEMENT LLC ” Practice Location

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