Provider Demographics
NPI:1053701565
Name:JM FAMILY ENTERPRISES, INC.
Entity type:Organization
Organization Name:JM FAMILY ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GROUP VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-596-3976
Mailing Address - Street 1:111 JIM MORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1701
Mailing Address - Country:US
Mailing Address - Phone:954-429-2418
Mailing Address - Fax:954-429-2148
Practice Address - Street 1:9985 PRITCHARD RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32219-2894
Practice Address - Country:US
Practice Address - Phone:904-378-4652
Practice Address - Fax:904-378-4568
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JM FAMILY ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care