Organization
JL GRAN SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE L MIRO (PRESIDENT)
(754) 234-1184
Entity
Organization
Contact information
Practice address
3435 WESTWOOD DR, TITUSVILLE, FL 32796
(754) 234-1184
(321) 445-4757
Mailing address
3435 WESTWOOD DR, TITUSVILLE, FL 32796
(754) 234-1184
(321) 445-4757
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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