Provider Demographics
NPI:1649572942
Name:JCR MEDICAL COORDINATION, INC
Entity type:Organization
Organization Name:JCR MEDICAL COORDINATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-835-5543
Mailing Address - Street 1:5400 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 401-410
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5312
Mailing Address - Country:US
Mailing Address - Phone:954-835-5543
Mailing Address - Fax:954-835-5549
Practice Address - Street 1:5400 S UNIVERSITY DR
Practice Address - Street 2:SUITE 401-410
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5312
Practice Address - Country:US
Practice Address - Phone:954-835-5543
Practice Address - Fax:954-835-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008467-1111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty