Healthcare Provider Details

I. General information

NPI: 1538405543
Provider Name (Legal Business Name): JUNO MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14147 US HIGHWAY 1
JUNO BEACH FL
33408-1427
US

IV. Provider business mailing address

14147 US HIGHWAY 1
JUNO BEACH FL
33408-1427
US

V. Phone/Fax

Practice location:
  • Phone: 561-848-3861
  • Fax:
Mailing address:
  • Phone: 561-848-3861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH1365
License Number StateFL

VIII. Authorized Official

Name: SEAN JOHNSON
Title or Position: OWNER/ORESIDENT
Credential: DC
Phone: 561-848-3861