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Organization
JUPITER MEDICAL GROUP P A
Active
Organization
JUPITER MEDICAL GROUP P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJENDRA K. BANSAL M.D. (MEDICAL DIRECTOR)
(561) 746-2411
Entity
Organization
Contact information
Practice address
875 MILITARY TRL, SUITE 200, JUPITER, FL 33458-5700
(561) 746-2411
(561) 354-0012
Mailing address
875 MILITARY TRL, SUITE 200, JUPITER, FL 33458-5700
(561) 746-2411
(561) 354-0012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0049954
FL
207RC0000X
Cardiovascular Disease Physician
ME0076025
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
ME0049954
FL
Other
Enumeration date
07/15/2006
Last updated
01/30/2012
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