Provider Demographics
NPI:1265467468
Name:CHRISTIAN R LE BIENVENU M D PA
Entity Type:Organization
Organization Name:CHRISTIAN R LE BIENVENU M D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:LE BIENVENU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-796-8181
Mailing Address - Street 1:2901CORAL HILLS DRIVE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-796-8181
Mailing Address - Fax:954-796-8191
Practice Address - Street 1:2901CORAL HILLS DRIVE
Practice Address - Street 2:SUITE 390
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-796-8181
Practice Address - Fax:954-796-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12187OtherBLUE CROSS
FL005767OtherNEIGHBORHOOD HEALTH
FL107312OtherHUMANA
FL293595OtherAVMED
FL2556568004OtherCIGNA
FL107312OtherHUMANA
FLE46855Medicare UPIN