Healthcare Provider Details

I. General information

NPI: 1689362741
Provider Name (Legal Business Name): ROSE KHINE HONOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 UNIVERSITY BLVD STE 204
JUPITER FL
33458-2788
US

IV. Provider business mailing address

601 UNIVERSITY BLVD STE 204
JUPITER FL
33458-2788
US

V. Phone/Fax

Practice location:
  • Phone: 561-747-5066
  • Fax: 855-446-4546
Mailing address:
  • Phone: 561-747-5066
  • Fax: 855-466-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME183769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: