NPIMap

Organization Active NPI

Jce Family Medicine LLC

  • Primary Care Clinic/Center
  • Fort Pierce, FL
National Provider Identifier
1114354032
Registry record updated Dec 17, 2013
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Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
OS6690 Issued in FL
Legal business name
JCE FAMILY MEDICINE LLC
Practice address
4640 S 25TH St
Fort Pierce, FL 34981-5057
Phone
(772) 466-8884
Fax
(772) 466-8832
NPI assigned
Oct 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Juan Guillermo Coquelet, D.O.
Title
President
Phone
(772) 466-8884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X OS6690 FL Primary

Addresses

Primary practice location

4640 S 25TH St
Fort Pierce, FL 34981-5057

Mailing address

PO Box 13450
Fort Pierce, FL 34979-3450
Phone (772) 466-8884

National Provider Directory

National Provider Directory

Locations

1701 SE Hillmoor Dr
Ste 9
Port St Lucie, FL 34952
Phone (772) 335-0888

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1114354032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13450",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349793450",
            "telephone_number": "772-466-8884",
            "fax_number": "772-466-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-466-8884",
            "fax_number": "772-466-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "COQUELET",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "GUILLERMO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-466-8884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS6690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.