Provider Demographics
NPI:1124368279
Name:GENEVE, JEAN-MARC (PA)
Entity Type:Individual
Prefix:
First Name:JEAN-MARC
Middle Name:
Last Name:GENEVE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 KNUTH RD
Mailing Address - Street 2:STE 200
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4693
Mailing Address - Country:US
Mailing Address - Phone:561-204-4800
Mailing Address - Fax:561-798-7700
Practice Address - Street 1:13001 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9203
Practice Address - Country:US
Practice Address - Phone:561-798-3300
Practice Address - Fax:561-798-7700
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3232012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIN PROCESSMedicaid
FLIN PROCESSMedicaid