Provider Demographics
NPI:1669245353
Name:JK MEDICAL STAFFING LLC
Entity type:Organization
Organization Name:JK MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARDELL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MUSGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-708-4861
Mailing Address - Street 1:1031 IVES DAIRY RD STE 228
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2538
Mailing Address - Country:US
Mailing Address - Phone:954-708-4861
Mailing Address - Fax:954-239-6111
Practice Address - Street 1:1031 IVES DAIRY RD STE 228
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:954-708-4861
Practice Address - Fax:954-239-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty