TAOLIN C JEN MD PA
Ambulatory Health at Shircliff Way, Jacksonville, FL

License number
Florida P93000013252
Category
Ambulatory Health
Type
Primary Care
Owner
Name: TAOLIN C JEN M.D.
Title: PRESIDENT
Phone: (904) 387-9033
Address
Address
3 Shircliff Way SUITE 614, Jacksonville, FL 32204
National Provider ID: 1881912061
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Taolin C. Jen, M.D., PA

Jacksonville, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Taolin Jen MD
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Feb 22, 1993
Inactive since:
Sep 27, 2013
Phone:
(904) 387-9033 (Phone)
Addresses:
1820 Barrs St, Jacksonville, FL 32204
3 Shircliff Way, Jacksonville, FL 32204
PO Box 551132, Jacksonville, FL 32255
10052 Deercreek Clb Rd E, Jacksonville, FL 32256
State ID:
P93000013252
Business type:
Florida Profit Corporation
President, Secretary:
Taolin C. Jen President, Secretary, inactive
Agent:
Taolin Jen,10052 Deercreek Clb Rd, Jacksonville, FL 32256 (Physical)
EIN:
59-3167319

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