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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
RAJENDRA K. BANSAL MD (OWNER)
(561) 746-2411
Entity
Organization
Contact information
Practice address
941 SE 1ST ST, BELLE GLADE, FL 33430-4353
(561) 992-4393
(561) 992-4394
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
—
—
Other
Enumeration date
12/18/2007
Last updated
12/26/2007
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