# JT MEDICAL ASSIST, LLC

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

## Provider details

- **NPI number:** 1891478525
- **Authorized official:** JEANETTE TULLER (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (954) 258-4014

## Contact information

- **Practice address:** 4948 NW 49TH CT, COCONUT CREEK, FL 33073-4908
- **Practice address phone:** (954) 258-4014
- **Mailing address:** 4948 NW 49TH CT, COCONUT CREEK, FL 33073-4908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2023
- **Last updated:** 08/09/2023