Provider Demographics
NPI:1427811470
Name:JENNIFER MURDOCK MD, PLLC
Entity type:Organization
Organization Name:JENNIFER MURDOCK MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-315-5577
Mailing Address - Street 1:12750 NW 17TH ST UNIT 226
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1423
Mailing Address - Country:US
Mailing Address - Phone:305-315-5577
Mailing Address - Fax:832-324-6986
Practice Address - Street 1:12750 NW 17TH ST UNIT 226
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-1423
Practice Address - Country:US
Practice Address - Phone:305-315-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538401583OtherNPI