Provider Demographics
NPI:1508553876
Name:GERMINAL, JEANLUS OCEAN
Entity Type:Individual
Prefix:MR
First Name:JEANLUS
Middle Name:OCEAN
Last Name:GERMINAL
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 1:6208 SW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2857
Mailing Address - Country:US
Mailing Address - Phone:786-416-3853
Mailing Address - Fax:
Practice Address - Street 1:5030 BRUNSON DR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2412
Practice Address - Country:US
Practice Address - Phone:786-416-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030744367500000X
TX1129158367500000X
FL9358445163W00000X
FLRN9358445163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse