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General NPI Number Information
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NPI Number | 1134842610
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Entity Type | Organization
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Legal Business Name | JUPITER EYE DOCTORS, LLC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 10088 INDIANTOWN RD STE B
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City | JUPITER
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State | FL
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Zip | 33478-4738
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Country | US
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Telephone | 561-250-0677
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Fax |
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Provider Business Mailing Address
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Address Line | 10088 INDIANTOWN RD STE B
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City | JUPITER
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State | FL
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Zip | 33478-4738
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Country | US
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Telephone | 561-250-0677
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. DOMINICK GOLIO
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Credential | MD
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Telephone | 305-534-0121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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