Provider Demographics
NPI:1518344852
Name:ALCIME, JEAN-CLAUDE
Entity Type:Individual
Prefix:
First Name:JEAN-CLAUDE
Middle Name:
Last Name:ALCIME
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 1:450 SW VIOLET AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1973
Mailing Address - Country:US
Mailing Address - Phone:603-231-9263
Mailing Address - Fax:877-310-8660
Practice Address - Street 1:450 SW VIOLET AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1973
Practice Address - Country:US
Practice Address - Phone:603-231-9263
Practice Address - Fax:877-310-8660
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility