Provider Demographics
NPI:1487088282
Name:JCMD MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:JCMD MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTY
Authorized Official - Last Name:CARROZZELLA
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:813-659-2897
Mailing Address - Street 1:7575 DR PHILLIPS BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7216
Mailing Address - Country:US
Mailing Address - Phone:407-507-3837
Mailing Address - Fax:407-507-3841
Practice Address - Street 1:7575 DR PHILLIPS BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7216
Practice Address - Country:US
Practice Address - Phone:407-507-3837
Practice Address - Fax:407-507-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty