Organization
JLS ADVANED PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON STOREY-PETRILLO APRN, FNP-C, PMHNP-C (PRESIDENT)
(954) 600-4502
Entity
Organization
Contact information
Practice address
5200 S STERLING RANCH CIR, DAVIE, FL 33314-7255
(954) 600-4502
Mailing address
5200 S STERLING RANCH CIR, DAVIE, FL 33314-7255
(954) 600-4502
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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