Provider Demographics
NPI:1457320681
Name:JEAN-BAPTISTE, LYONEL A (MD)
Entity Type:Individual
Prefix:
First Name:LYONEL
Middle Name:A
Last Name:JEAN-BAPTISTE
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 1:1021 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:MOORE HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33471-6206
Mailing Address - Country:US
Mailing Address - Phone:863-946-0405
Mailing Address - Fax:844-542-8959
Practice Address - Street 1:1021 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:MOORE HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33471-6206
Practice Address - Country:US
Practice Address - Phone:863-946-0405
Practice Address - Fax:844-542-8959
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23712OtherBCBS PROVIDER #
FL373638500Medicaid
FL23712OtherBCBS PROVIDER #
FLF72721Medicare UPIN