| Jld Medical Services Inc | |
|
7100 W 20th Ave Suite 706 Hialeah FL 33016-1897 | |
| (305) 821-6112 | |
| (305) 821-9050 |
| Full Name | Jld Medical Services Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7100 W 20th Ave, Hialeah, Florida |
| Authorized Official Name and Position | Jorge Luis Diaz (PRESIDENT) |
| Authorized Official Contact | 3058216112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jld Medical Services Inc 7100 W 20th Ave Suite 706 Hialeah FL 33016-1897 Ph: (305) 821-6112 | Jld Medical Services Inc 7100 W 20th Ave Suite 706 Hialeah FL 33016-1897 Ph: (305) 821-6112 |
| NPI Number | 1225056997 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 10/17/2011 |
| Medicare PECOS PAC ID | 4880656958 |
|---|---|
| Medicare Enrollment ID | O20041101000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225056997 | NPI | - | NPPES |
| 260071400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jorge L. Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346279809 PECOS PAC ID: 1951363027 Enrollment ID: I20120529000518 |
| Provider Name | Yunior Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053844985 PECOS PAC ID: 7719247188 Enrollment ID: I20180202000357 |
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