MEDICARE: THE JEZREEL COMPANY DBA 3 CORDS FAMILY MEDICINE

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

General Provider Information

NPI Number	:	1568160026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE JEZREEL COMPANY DBA 3 CORDS FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	1099 WATERBROOK LN
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-2831
Country	:	US
Telephone Number	:	954-551-6972
Fax Number	:	954-385-1019

Provider Business Practice Location Address
First Line	:	1099 WATERBROOK LN
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-2831
Country	:	US
Telephone Number	:	954-551-6972
Fax Number	:	954-385-1019

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER ROSE
Credential	:	NP
Telephone Number	:	954-551-6972

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	03/27/2026

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