Provider Demographics
NPI:1083079834
Name:MORISSAINT, JEAN
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:MORISSAINT
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 1:5758 S SEMORAN BLVD
Mailing Address - Street 2:BUILDING E
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4818
Mailing Address - Country:US
Mailing Address - Phone:407-757-0927
Mailing Address - Fax:
Practice Address - Street 1:5758 S SEMORAN BLVD
Practice Address - Street 2:BUILDING E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4818
Practice Address - Country:US
Practice Address - Phone:407-757-0927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation