Organization
53RD STREET MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BARLOW (PRESIDENT, JUPITER PROFESSIONAL DEV)
(561) 748-2889
Entity
Organization
Contact information
Practice address
2331 NE 53RD ST, FT LAUDERDALE, FL 33308-3235
(954) 491-9700
Mailing address
PO BOX 7240, JUPITER, FL 33468-7240
(561) 748-2889
(561) 748-1523
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
ME83014
FL
Other
Enumeration date
07/12/2012
Last updated
08/01/2012
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