Provider Demographics
NPI:1548058266
Name:JDE MEDICAL P.A
Entity type:Organization
Organization Name:JDE MEDICAL P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-999-3507
Mailing Address - Street 1:8600 NW 36TH ST STE 501
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6688
Mailing Address - Country:US
Mailing Address - Phone:786-999-3507
Mailing Address - Fax:844-670-0904
Practice Address - Street 1:8600 NW 36TH ST STE 501
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6688
Practice Address - Country:US
Practice Address - Phone:786-999-3507
Practice Address - Fax:844-670-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty