Provider Demographics
NPI:1447570387
Name:K&J PROFESSIONAL HEALTH INC
Entity Type:Organization
Organization Name:K&J PROFESSIONAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KLEIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCO
Authorized Official - Suffix:I
Authorized Official - Credentials:MA
Authorized Official - Phone:305-819-2243
Mailing Address - Street 1:1490 W 49TH PL STE 450
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3196
Mailing Address - Country:US
Mailing Address - Phone:305-819-2243
Mailing Address - Fax:
Practice Address - Street 1:1490 W 49TH PL STE 450
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3196
Practice Address - Country:US
Practice Address - Phone:305-819-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation