Provider Demographics
NPI:1538286372
Name:K JEAN-CHARLES MD PA
Entity Type:Organization
Organization Name:K JEAN-CHARLES MD PA
Other - Org Name:LINTON MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENSY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-278-3733
Mailing Address - Street 1:PO BOX 480397
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33448-0397
Mailing Address - Country:US
Mailing Address - Phone:561-278-3733
Mailing Address - Fax:561-276-9845
Practice Address - Street 1:601 N CONGRESS AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4703
Practice Address - Country:US
Practice Address - Phone:561-278-3733
Practice Address - Fax:561-276-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3009855OtherAETNA INC
FLCK5370OtherRAILROAD MEDICARE
FL34490OtherBLUE CROSS
FL3009855OtherAETNA INC