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General NPI Number Information
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NPI Number | 1144638834
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Entity Type | Organization
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Legal Business Name | HIGH POINT PLASTIC SURGERY, LLC
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Dates
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Enumeration Date | 07/26/2014
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Last Update Date | 07/26/2014
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Provider Practice Location Address
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Address Line | 3535 MILITARY TRL #204
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City | JUPITER
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State | FL
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Zip | 33458-5009
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Country | US
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Telephone | 617-721-5891
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 MILITARY TRL #204
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City | JUPITER
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State | FL
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Zip | 33458-5009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON S COOPER
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Credential | MD
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Telephone | 617-721-5891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME104001
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License Number State | FL
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