Provider Demographics
NPI:1144761933
Name:JTHEALTH, LLC
Entity Type:Organization
Organization Name:JTHEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEEKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-685-4850
Mailing Address - Street 1:11764 MARCO BEACH DR STE 9A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7684
Mailing Address - Country:US
Mailing Address - Phone:904-685-4850
Mailing Address - Fax:904-685-4850
Practice Address - Street 1:11764 MARCO BEACH DR STE 9A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7684
Practice Address - Country:US
Practice Address - Phone:904-685-4850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization