Organization
JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK LLC
Active
Organization
JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK LLC
Active
Other names
JenCare Neighborhood Medical Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CHEN (AUTHORIZED OFFICIAL)
(305) 831-4722
Entity
Organization
Contact information
Practice address
524 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3609
(305) 653-1770
Mailing address
1395 NW 167TH ST, MIAMI, FL 33169-5710
(305) 628-6117
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
05/22/2012
Last updated
02/20/2025
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