Provider Demographics
NPI:1083971360
Name:JET MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:JET MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHOKSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:352-203-4408
Mailing Address - Street 1:2221 SW 19TH AVENUE RD UNIT 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7758
Mailing Address - Country:US
Mailing Address - Phone:522-034-4083
Mailing Address - Fax:844-602-4616
Practice Address - Street 1:2221 SW 19 AV RD
Practice Address - Street 2:STE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-629-9100
Practice Address - Fax:352-629-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 964162083P0500X
FLME96416261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Single Specialty