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General NPI Number Information
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NPI Number | 1245906809
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Entity Type | Organization
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Legal Business Name | ANESTHESIOLOGY OF JUPITER PA
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 900 VILLAGE SQUARE XING STE 100
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4547
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Country | US
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Telephone | 877-328-1119
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 744069
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City | ATLANTA
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State | GA
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Zip | 30374-4069
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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 | OFFICER
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Name | KAREN VAUGHN
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Credential |
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Telephone | 404-450-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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