# JUPITER MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407418395
- **Authorized official:** DANIEL BANGART DPM (MANAGER)
- **Authorized official phone:** (623) 974-0522

## Contact information

- **Practice address:** 13660 N 94TH DR \# D-1, PEORIA, AZ 85381-4836
- **Practice address phone:** (623) 974-0522
- **Mailing address:** 7558 W. THUNDERBIRD RD., STE. 1, BOX 606, PEORIA, AZ 85381-4836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2019
- **Last updated:** 12/19/2019