Provider Demographics
NPI:1225575012
Name:JEAN-BAPTISTE, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:JEAN-BAPTISTE
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 1:175 MIDDLE ST UNIT 1201
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 UNIVERSITY SQUARE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5513
Practice Address - Country:US
Practice Address - Phone:813-981-0815
Practice Address - Fax:813-606-4260
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician