# JIL MEDICAL CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437027687
- **Authorized official:** OCTAVIE LAURA BIH AMBE FNP (OWNER)
- **Authorized official phone:** (240) 467-4645

## Contact information

- **Practice address:** 11305 POLARIS DR, UPPER MARLBORO, MD 20774-3548
- **Practice address phone:** (240) 467-4645
- **Mailing address:** 11305 POLARIS DR, UPPER MARLBORO, MD 20774-3548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/28/2025
- **Last updated:** 10/28/2025