JUPITER LAKES PHYSICIAN GROUP PA (NPI# 1154969699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154969699 |
| Entity Type | Organization |
| Organization Name | JUPITER LAKES PHYSICIAN GROUP PA |
| Practice Address |
210 Jupiter Lakes Blvd Ste 4104 Jupiter FL 33458-7190 |
| Practice Telephone | 5617443467 |
| Practice Fax Number | 5617483272 |
| Mailing Telephone | 5617443467 |
| Mailing Fax Number | 5617483272 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | MICHELLE FULLER (ADMINISTRATOR) |
| Authorized Official Telephone | 5613983661 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
210 JUPITER LAKES BLVD STE 4104 |
| City | JUPITER |
| State | FL |
| Zip Code | 33458-7190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538780978 | Palm Beach Concierge Pt, LLC | Physical Therapist | 1166 Egret Cir S, Jupiter, FL 33458 | 2020-04-27 |
| 1346714789 | Shirley Dumas Gilbert | Counselor | 1132 W Indiantown Rd Unit 202, Jupiter, FL 33458 | 2019-01-18 |
| 1326518986 | Donald George Williams Jr. | Pharmacist | 5500 Military Trail, Jupiter, FL 33458 | 2018-11-27 |
| 1306329693 | William A Tison IIi | Physician Assistant | 2055 Military Trail Suite 204, Jupiter, FL 33458 | 2018-09-12 |
| 1588146930 | Joanna Peros | Psychologist | 210 Jupiter Lakes Blvd. Unit 3102, Jupiter, FL 33458 | 2018-09-02 |
| 1528558301 | Brian Pratt | Registered Nurse | 871 University Blvd Apt 207, Jupiter, FL 33458 | 2018-05-16 |
| 1306352133 | Katherine Janis Rivera | Nurse Anesthetist, Certified Registered | Jupiter Medical Center 1210 Old Dixie Hwy, Jupiter, FL 33458 | 2017-12-15 |
| 1992235436 | Barborka Schmidt | Pharmacist | 6650 W Indiantown Road, Suite 100, Aarav Pharmacy LLC, Jupiter, FL 33458 | 2017-06-18 |
| 1114453834 | Elite-e Counseling | Social Worker | 2055 Military Trail Suite 306 Jupiter, Jupiter, FL 33458 | 2017-05-02 |
| 1669910667 | Kristy Lee Caronia | Nurse Anesthetist, Certified Registered | 175 Edenberry Ave, Jupiter, FL 33458 | 2017-02-09 |
| Find all providers in zip 33458 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033727441 | Nu Forme Healthcare LLC | Clinic/Center | 109 Majorca Way Apt 103, Jupiter, FL 33458-1096 | 2020-07-22 |
| 1740793504 | Hp Primary Care, LLC | Clinic/Center | 1090 Jupiter Park Dr Ste 200, Jupiter, FL 33458-8939 | 2017-11-14 |
| 1952419608 | Castleton Family Practice LLC | Clinic/Center | 210 Jupiter Lakes Boulevard, Building 3000, Suite 102, Jupiter, FL 33458-7831 | 2006-08-25 |
| 1245771336 | Internal Medicine Group Inc. | Clinic/Center | 278 Sussex Cir, Jupiter, FL 33458-8118 | 2017-03-09 |
| 1619322823 | Medi-weightloss Clinic of Jupiter | Clinic/Center | 4600 Military Trl, Suite 114, Jupiter, FL 33458-4810 | 2016-04-26 |
| 1457723215 | Medflorida, LLC | Clinic/Center | 3889 Military Trl, Jupiter, FL 33458-2923 | 2015-10-20 |
| 1376859744 | Daniel Igal Nuchovich,m.d., P.a. | Clinic/Center | 175 Toney Penna Dr, Ste 101, Jupiter, FL 33458-5755 | 2010-08-24 |
| 1003849258 | Bruce H Berman,md,pa | Clinic/Center | 675 W Indiantown Rd, Suite 100, Jupiter, FL 33458-7548 | 2006-07-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.