| Jd Medical Group, Llc | |
|
3044 Ocean Port Dr Las Vegas NV 89117-0210 | |
| (702) 606-1161 | |
| Not Available |
| Full Name | Jd Medical Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3044 Ocean Port Dr, Las Vegas, Nevada |
| Authorized Official Name and Position | Maria Jill Alfonso (NURSE PRACTITIONER) |
| Authorized Official Contact | 7026061161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jd Medical Group, Llc 3044 Ocean Port Dr Las Vegas NV 89117-0210 Ph: (702) 606-1161 | Jd Medical Group, Llc 3044 Ocean Port Dr Las Vegas NV 89117-0210 Ph: (702) 606-1161 |
| NPI Number | 1376307058 |
|---|---|
| Provider Enumeration Date | 02/12/2024 |
| Last Update Date | 02/12/2024 |
| Medicare PECOS PAC ID | 2668817750 |
|---|---|
| Medicare Enrollment ID | O20240228002869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376307058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | David Elizer Apolinario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457089039 PECOS PAC ID: 5294106340 Enrollment ID: I20230127000583 |
| Provider Name | Maria Jill Buena Alfonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982332227 PECOS PAC ID: 7618340597 Enrollment ID: I20230223000455 |
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