Individual
JOSE E JAEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6619 S DIXIE HWY, PMB 272, MIAMI, FL 33143-7919
(305) 669-5151
(305) 669-2151
Mailing address
6141 SUNSET DR, SUITE #403, SOUTH MIAMI, FL 33143-5028
(305) 669-5151
(305) 669-2151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME38391
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041500600
—
FL
01
—
96800V
MEDICARE ID
FL
Enumeration date
07/26/2006
Last updated
05/28/2014
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