Provider Demographics
NPI:1376285924
Name:JEWELS CAPITAL PREVENTATIVE CARE
Entity Type:Organization
Organization Name:JEWELS CAPITAL PREVENTATIVE CARE
Other - Org Name:JCPC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TJANDERA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-348-1335
Mailing Address - Street 1:2509 ARVAH BRANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-9106
Mailing Address - Country:US
Mailing Address - Phone:786-348-1335
Mailing Address - Fax:
Practice Address - Street 1:8511 BULL HEADLEY RD STE 400
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-5132
Practice Address - Country:US
Practice Address - Phone:850-779-0719
Practice Address - Fax:786-299-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy