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General NPI Number Information
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NPI Number | 1295042760
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Entity Type | Organization
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Legal Business Name | JUPITER CANCER INSTITUTE, PA
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 431 UNIVERSITY BLVD
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City | JUPITER
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State | FL
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Zip | 33458-3103
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Country | US
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Telephone | 561-748-2488
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Fax | 561-748-2468
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Provider Business Mailing Address
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Address Line | 431 UNIVERSITY BLVD
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City | JUPITER
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State | FL
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Zip | 33458-3103
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Country | US
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Telephone | 561-748-2488
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Fax | 561-748-2468
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JULIE WELLS
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Credential |
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Telephone | 561-748-2488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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