Provider Demographics
NPI:1306595798
Name:JD MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:JD MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:HUMBERTO
Authorized Official - Last Name:HECHAVARRIA MIYARES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MD
Authorized Official - Phone:786-469-0103
Mailing Address - Street 1:9159 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2302
Mailing Address - Country:US
Mailing Address - Phone:786-469-0103
Mailing Address - Fax:
Practice Address - Street 1:9159 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2302
Practice Address - Country:US
Practice Address - Phone:786-469-0103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty