MEDICARE: JIREH MEDICAL CENTER CORP

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1932566965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIREH MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	7900 NW 33RD ST STE 101
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2209
Country	:	US
Telephone Number	:	954-962-5300
Fax Number	:	954-962-0100

Provider Business Practice Location Address
First Line	:	7900 NW 33RD ST STE 101
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2209
Country	:	US
Telephone Number	:	954-962-5300
Fax Number	:	954-962-0100

Authorized Official
Title or Position	:	MD
Name	:	DR. MARTA ROSA FERNANDEZ
Credential	:	MD
Telephone Number	:	954-962-5300

Provider Enumeration Date	:	01/21/2016
Last Update Date	:	06/12/2019

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Directions to “JIREH MEDICAL CENTER CORP ” Practice Location

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