MEDICARE: JD MEDICAL GROUP 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

General Provider Information

NPI Number	:	1881579910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JD MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	3601 W SAHARA AVE STE 208
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:	702-570-9545
Fax Number	:	702-570-9547

Provider Business Practice Location Address
First Line	:	3601 W SAHARA AVE STE 208
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:	702-570-9545
Fax Number	:	702-570-9547

Authorized Official
Title or Position	:	OWNER
Name	:	MARIA ALFONSO
Credential	:
Telephone Number	:	702-570-9545

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	08/07/2025

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Directions to “JD MEDICAL GROUP LLC ” Practice Location

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