Organization
JUVENIS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GOODKIN (CEO)
(954) 494-3711
Entity
Organization
Contact information
Practice address
4750 N FEDERAL HWY STE 203, FORT LAUDERDALE, FL 33308-4609
(954) 494-3711
(954) 776-9953
Mailing address
4750 N FEDERAL HWY STE 203, FORT LAUDERDALE, FL 33308-4609
(954) 494-3711
(954) 776-9953
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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