Provider Demographics
NPI:1326514167
Name:JAMES J JENNINGS MD LLC
Entity Type:Organization
Organization Name:JAMES J JENNINGS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-803-1519
Mailing Address - Street 1:11921 SOUTH DIXIE HWY
Mailing Address - Street 2:STE. 201
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:786-868-0503
Mailing Address - Fax:786-524-0956
Practice Address - Street 1:11921 SOUTH DIXIE HWY
Practice Address - Street 2:STE. 201
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:786-868-0503
Practice Address - Fax:786-524-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty