| |
875 Military Trl Suite 200 Jupiter FL 33458-5700 | |
(561) 746-2411 | |
(561) 354-0012 |
Full Name | |
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Speciality | Internal Medicine |
Location | 875 Military Trl, Jupiter, Florida |
Authorized Official Name and Position | Rajendra K. Bansal (PRESIDENT) |
Authorized Official Contact | 5617462411 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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875 Military Trl Suite 200 Jupiter FL 33458-5700 Ph: (561) 746-2411 | 875 Military Trl Suite 200 Jupiter FL 33458-5700 Ph: (561) 746-2411 |
NPI Number | 1871777680 |
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Provider Enumeration Date | 12/28/2007 |
Last Update Date | 02/02/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871777680 | NPI | - | NPPES |
ME0049954 | Other | FL | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | ME0049954 (Florida) | Secondary |
207R00000X | Internal Medicine | ME0049954 (Florida) | Primary |
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