Provider Demographics
NPI:1962411454
Name:JD MOBILE HEALTH SERVICES INC.
Entity type:Organization
Organization Name:JD MOBILE HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-419-7172
Mailing Address - Street 1:PO BOX 951433
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-1433
Mailing Address - Country:US
Mailing Address - Phone:407-416-7172
Mailing Address - Fax:407-321-9337
Practice Address - Street 1:511 STILL FOREST TERRACE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8371
Practice Address - Country:US
Practice Address - Phone:407-416-7172
Practice Address - Fax:407-321-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056402OtherLICENSE
FLH05355Medicare UPIN
FL056402OtherLICENSE
FLK9328Medicare ID - Type Unspecified
FL80727YMedicare PIN
FL2846IUMedicare ID - Type Unspecified