Organization
JT MEDICAL ASSIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE TULLER (PHYSICIAN ASSISTANT)
(954) 258-4014
Entity
Organization
Contact information
Practice address
4948 NW 49TH CT, COCONUT CREEK, FL 33073-4908
(954) 258-4014
Mailing address
4948 NW 49TH CT, COCONUT CREEK, FL 33073-4908
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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