Organization
JUPITER LAKES PHYSICIAN GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE FULLER (ADMINISTRATOR)
(561) 398-3661
Entity
Organization
Contact information
Practice address
210 JUPITER LAKES BLVD STE 4104, JUPITER, FL 33458-7190
(561) 744-3467
(561) 748-3272
Mailing address
210 JUPITER LAKES BLVD STE 4104, JUPITER, FL 33458-7190
(561) 744-3467
(561) 748-3272
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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