Provider Demographics
NPI:1801199237
Name:CHECKMATE INC
Entity Type:Organization
Organization Name:CHECKMATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:786-344-5284
Mailing Address - Street 1:2753 STARDUST CT
Mailing Address - Street 2:CT #9
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-2808
Mailing Address - Country:US
Mailing Address - Phone:786-344-5284
Mailing Address - Fax:
Practice Address - Street 1:2753 STARDUST CT
Practice Address - Street 2:CT#9
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-2808
Practice Address - Country:US
Practice Address - Phone:786-344-5284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL616231251J00000X, 261QH0100X, 261QU0200X, 305R00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No251J00000XAgenciesNursing Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL616231OtherLPN NURSE