Healthcare Provider Details

I. General information

NPI: 1740196500
Provider Name (Legal Business Name): DR. JASON ANDREW MCMICHEAUX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 S US HIGHWAY 1 STE 200
JUPITER FL
33477-5159
US

IV. Provider business mailing address

318 S US HIGHWAY 1 STE 200
JUPITER FL
33477-5159
US

V. Phone/Fax

Practice location:
  • Phone: 561-815-3653
  • Fax: 772-477-0001
Mailing address:
  • Phone: 561-815-3653
  • Fax: 772-477-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: