Organization
JUPITER PEDIATRIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP COLAIZZO MD (PRESIDENT)
(561) 575-9876
Entity
Organization
Contact information
Practice address
6650 W INDIANTOWN RD, SUITE 110, JUPITER, FL 33458-4628
(561) 575-9876
(561) 575-2858
Mailing address
6650 W INDIANTOWN RD, SUITE 110, JUPITER, FL 33458-4628
(561) 575-9876
(561) 575-2858
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10262880
—
FL
01
—
11832A
BCBS
FL
01
—
21874
BCBS
FL
Enumeration date
07/12/2006
Last updated
10/22/2019
Update your record
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