Provider Demographics
NPI:1902382278
Name:JUPITER CHIROPRACTIC AND SPORTS MEDICINE, PLLC
Entity Type:Organization
Organization Name:JUPITER CHIROPRACTIC AND SPORTS MEDICINE, PLLC
Other - Org Name:KAREL LEWIT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BIONDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-529-3646
Mailing Address - Street 1:1701 MILITARY TRL STE 145B
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6330
Mailing Address - Country:US
Mailing Address - Phone:561-529-3646
Mailing Address - Fax:561-529-3538
Practice Address - Street 1:1701 MILITARY TRL STE 145B
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6330
Practice Address - Country:US
Practice Address - Phone:561-529-3646
Practice Address - Fax:561-529-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11952261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service