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NPI Code Detail

MEDICARE: JUNO DOCTORS GROUP, LLC

MEDICARE: JUNO DOCTORS GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HCC10607OTHERFLAHCA LICENSE

General Provider Information

NPI Number : 1225401201
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUNO DOCTORS GROUP, LLC
Provider Business Mailing Address
First Line : 13211 US HIGHWAY 1
Second Line :
City : JUNO BEACH
State : FL
Zip : 33408-2222
Country : US
Telephone Number : 561-337-3200
Fax Number : 844-681-2025
Provider Business Practice Location Address
First Line : 13211 US HIGHWAY 1
Second Line :
City : JUNO BEACH
State : FL
Zip : 33408-2222
Country : US
Telephone Number : 561-337-3200
Fax Number : 844-681-2025
Authorized Official
Title or Position : CEO
Name : GLENN COHEN
Credential :
Telephone Number : 561-337-3200
Provider Enumeration Date : 11/12/2015
Last Update Date : 09/21/2016

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