| |
140 Jupiter Lakes Blvd Ste A, Jupiter, FL 33458-7196 | |
(561) 320-9298 | |
(772) 288-3341 |
Full Name | |
---|---|
Type | Facility |
Speciality | Non-pharmacy Dispensing Site |
Location | 140 Jupiter Lakes Blvd Ste A, Jupiter, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083269955 | NPI | - | NPPES |
001593100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1601 Clint Moore Rd Ste 180, Boca Raton, FL 33487-5713 Ph: (561) 995-0229 | 140 Jupiter Lakes Blvd Ste A, Jupiter, FL 33458-7196 Ph: (561) 320-9298 |