Organization
JIL MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIE LAURA BIH AMBE FNP (OWNER)
(240) 467-4645
Entity
Organization
Contact information
Practice address
11305 POLARIS DR, UPPER MARLBORO, MD 20774-3548
(240) 467-4645
Mailing address
11305 POLARIS DR, UPPER MARLBORO, MD 20774-3548
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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