MEDICARE: JCP PROFESSIONAL CONSULTING 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	171W00000X	Contractor
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1821876145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JCP PROFESSIONAL CONSULTING LLC

Provider Business Mailing Address
First Line	:	3378 BARINA ST
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-5633
Country	:	US
Telephone Number	:	787-505-1090
Fax Number	:

Provider Business Practice Location Address
First Line	:	3378 BARINA ST
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-5633
Country	:	US
Telephone Number	:	787-505-1090
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACKELINE CUEVAS PEREZ
Credential	:
Telephone Number	:	787-505-1090

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	09/18/2023

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Directions to “JCP PROFESSIONAL CONSULTING LLC ” Practice Location

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