Provider Demographics
NPI:1538625520
Name:JSK MD LLC
Entity type:Organization
Organization Name:JSK MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:ASHWIN
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-732-6400
Mailing Address - Street 1:419 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0609
Mailing Address - Country:US
Mailing Address - Phone:352-732-6400
Mailing Address - Fax:352-671-5283
Practice Address - Street 1:419 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0609
Practice Address - Country:US
Practice Address - Phone:352-732-6400
Practice Address - Fax:352-671-5283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANJAY A PATEL MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-14
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty