Provider Demographics
NPI:1508257528
Name:JM FAMILY ENTERPRISE
Entity Type:Organization
Organization Name:JM FAMILY ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-969-3303
Mailing Address - Street 1:5350 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3409
Mailing Address - Country:US
Mailing Address - Phone:954-969-3303
Mailing Address - Fax:954-979-6097
Practice Address - Street 1:5350 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33073-3409
Practice Address - Country:US
Practice Address - Phone:954-969-3303
Practice Address - Fax:954-979-6097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 1388202261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center