Provider Demographics
NPI:1831981505
Name:JCR DMD LC
Entity type:Organization
Organization Name:JCR DMD LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:786-916-7400
Mailing Address - Street 1:3751 TAMIAMI TRL E
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6215
Mailing Address - Country:US
Mailing Address - Phone:239-399-0925
Mailing Address - Fax:239-304-8134
Practice Address - Street 1:26831 S TAMIAMI TRL UNIT 48
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7828
Practice Address - Country:US
Practice Address - Phone:239-399-0925
Practice Address - Fax:239-304-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental