Healthcare Provider Details

I. General information

NPI: 1275110058
Provider Name (Legal Business Name): JUNIPER HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 SE 6TH AVE STE A1
DELRAY BEACH FL
33483-5264
US

IV. Provider business mailing address

160 SE 6TH AVE STE A1
DELRAY BEACH FL
33483-5264
US

V. Phone/Fax

Practice location:
  • Phone: 561-475-4388
  • Fax:
Mailing address:
  • Phone: 561-475-4388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES LIM
Title or Position: MEMBER
Credential: MD
Phone: 561-475-4388