| Jiroma, Inc | |
|
1080 Edgewood Ave S Suite 7 Jacksonville FL 32205-5393 | |
| (904) 384-9007 | |
| (904) 384-2899 |
| Full Name | Jiroma, Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1080 Edgewood Ave S, Jacksonville, Florida |
| Authorized Official Name and Position | James Carlton Whited (PRESIDENT) |
| Authorized Official Contact | 9043849007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jiroma, Inc Po Box 380104 Jacksonville FL 32205-0604 Ph: (904) 384-9007 | Jiroma, Inc 1080 Edgewood Ave S Suite 7 Jacksonville FL 32205-5393 Ph: (904) 384-9007 |
| NPI Number | 1265749428 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 06/19/2013 |
| Medicare PECOS PAC ID | 6103099460 |
|---|---|
| Medicare Enrollment ID | O20111101000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265749428 | NPI | - | NPPES |
| Provider Name | James C Whited |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457668618 PECOS PAC ID: 4385817659 Enrollment ID: I20111101000712 |
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