MEDICARE: JUPITER MEDICAL CENTER PHYSICIANS GROUP

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
1	261QU0200X	Urgent Care Clinic/Center	HCC12419	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619415403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUPITER MEDICAL CENTER PHYSICIANS GROUP

Provider Business Mailing Address
First Line	:	PO BOX 9218
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33468-9218
Country	:	US
Telephone Number	:	561-263-2234
Fax Number	:	561-263-7260

Provider Business Practice Location Address
First Line	:	625 N FLAGLER DR
Second Line	:	SUITE 100
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-4027
Country	:	US
Telephone Number	:	561-263-7010
Fax Number	:	561-744-8215

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JUDY MAGALHAES
Credential	:	MSN, RN
Telephone Number	:	561-263-4354

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	04/10/2023

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