Provider Demographics
NPI:1821876145
Name:JCP PROFESSIONAL CONSULTING LLC
Entity Type:Organization
Organization Name:JCP PROFESSIONAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACKELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUEVAS PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-505-1090
Mailing Address - Street 1:3378 BARINA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-5633
Mailing Address - Country:US
Mailing Address - Phone:787-505-1090
Mailing Address - Fax:
Practice Address - Street 1:3378 BARINA ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-5633
Practice Address - Country:US
Practice Address - Phone:787-505-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty