Provider Demographics
NPI:1518370667
Name:JK MEDICAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:JK MEDICAL MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-658-4939
Mailing Address - Street 1:919 GRANT PL
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2313
Mailing Address - Country:US
Mailing Address - Phone:956-212-3872
Mailing Address - Fax:844-685-2273
Practice Address - Street 1:1001 SUDAN
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-3813
Practice Address - Country:US
Practice Address - Phone:956-212-3872
Practice Address - Fax:844-685-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health