Healthcare Provider Details

I. General information

NPI: 1477465730
Provider Name (Legal Business Name): JUPITER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 N OCEAN DR APT 4A
RIVIERA BEACH FL
33404-2513
US

IV. Provider business mailing address

19805 CASTLEWOOD DR
JUPITER FL
33458-1851
US

V. Phone/Fax

Practice location:
  • Phone: 561-202-7380
  • Fax:
Mailing address:
  • Phone: 561-202-7380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: RILEY BENEDETTO
Title or Position: MGR
Credential: BCBA
Phone: 561-202-7380