Provider Demographics
NPI:1285337402
Name:JEM'S PHYSICAL THERAPY & WELLNESS LLC
Entity type:Organization
Organization Name:JEM'S PHYSICAL THERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEMMA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CLT
Authorized Official - Phone:305-300-9613
Mailing Address - Street 1:18445 SW 267TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031-2239
Mailing Address - Country:US
Mailing Address - Phone:305-300-9613
Mailing Address - Fax:
Practice Address - Street 1:633 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6043
Practice Address - Country:US
Practice Address - Phone:305-300-9613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy