Healthcare Provider Details

I. General information

NPI: 1700469350
Provider Name (Legal Business Name): JOHN JOSEPH MULLEN JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2021
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2939 N MILITARY TRL
WEST PALM BEACH FL
33409-2916
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 561-863-5757
  • Fax: 561-863-6627
Mailing address:
  • Phone: 954-967-6400
  • Fax: 954-965-7339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS20942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: