Provider Demographics
NPI:1982345757
Name:JV MOBILE CARE
Entity Type:Organization
Organization Name:JV MOBILE CARE
Other - Org Name:JV MOBILE CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ- GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:321-537-7636
Mailing Address - Street 1:PO BOX 7325
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-0105
Mailing Address - Country:US
Mailing Address - Phone:321-537-7636
Mailing Address - Fax:
Practice Address - Street 1:31236 BRIDGEGATE DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-8219
Practice Address - Country:US
Practice Address - Phone:321-537-7636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JV MOBILE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-05
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care