Provider Demographics
NPI:1598424095
Name:BADETTE, JUNOT
Entity Type:Individual
Prefix:
First Name:JUNOT
Middle Name:
Last Name:BADETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6482 EMERALD DUNES DR APT 307
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2748
Mailing Address - Country:US
Mailing Address - Phone:917-436-7053
Mailing Address - Fax:
Practice Address - Street 1:6482 EMERALD DUNES DR APT 307
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2748
Practice Address - Country:US
Practice Address - Phone:917-436-7053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-12
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1125-P.A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical