Provider Demographics
NPI:1285655860
Name:JEANNOT, FRANCISCO A (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:A
Last Name:JEANNOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NW 70TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2364
Mailing Address - Country:US
Mailing Address - Phone:954-255-9930
Mailing Address - Fax:954-255-9932
Practice Address - Street 1:333 NW 70TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2364
Practice Address - Country:US
Practice Address - Phone:954-255-9930
Practice Address - Fax:954-255-9932
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
FLME80920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
35787OtherBLUE CROSS BLUE SHIELD OF FLORIDA
FLME80920OtherMEDICAL LICENSE