MUDIT JAIN MD PA
Osteopathic Medicine at 70 Ave, Fort Lauderdale, FL

License number
Florida ME75960
Category
Osteopathic Medicine
Type
Endocrinology, Diabetes & Metabolism
Owner
Name: MUDIT JAIN
Title: MD
Phone: (954) 585-6292
Address
Address
300 NW 70Th Ave SUITE 105, Fort Lauderdale, FL 33317
National Provider ID: 1114166733
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MUDIT JAIN, M.D., PA

300 NW 70 Ave STE 105, Fort Lauderdale, FL 33317

Doing business as:
Mudit Jain MD
Registration:
May 5, 1999
Phone:
(954) 585-6292 (Phone)
State ID:
P99000040708
Business type:
Florida Profit Corporation
President, Treasurer, Director, Secretary:
Mudit Md Jain (President, Treasurer, Director, Secretary), 300 NW 70 Ave, Fort Lauderdale, FL 33317 (Physical)
Agent:
Spiegel Utrera,343 Almeria Ave, Miami, FL 33134 (Physical)
EIN:
65-0916776

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