Provider Demographics
NPI:1477334746
Name:JDS CALM HEALTH CORP
Entity Type:Organization
Organization Name:JDS CALM HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MADRUGA PAU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:956-293-5008
Mailing Address - Street 1:14913 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-3935
Mailing Address - Country:US
Mailing Address - Phone:956-293-5008
Mailing Address - Fax:
Practice Address - Street 1:9963 SW 142ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6844
Practice Address - Country:US
Practice Address - Phone:786-360-5558
Practice Address - Fax:786-334-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty