Jupiter Health and Wellness, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JUPITER HEALTH AND WELLNESS, LLC

Practice address

4600 Military TRL Ste 110
Jupiter, FL 33458-4811

Phone

(561) 630-0303

Fax

(561) 630-6011

NPI assigned

Jun 12, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lori Bedoya

Title

Ceo

Phone

(561) 630-0303

Specialties & licenses 1

Addresses

Other names 1

• Jupiter Health And Wellness,LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1801389028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL STE 110",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584811",
            "telephone_number": "561-630-0303",
            "fax_number": "561-630-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL STE 110",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584811",
            "telephone_number": "561-630-0303",
            "fax_number": "561-630-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "BEDOYA",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-630-0303"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jupiter Health And Wellness,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jupiter, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.