Provider Demographics
NPI:1578598215
Name:LE BIENVENU, CHRISTIAN ROGER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ROGER
Last Name:LE BIENVENU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2901 CORAL HILLS DRIVE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-796-8181
Mailing Address - Fax:354-796-8191
Practice Address - Street 1:2901 CORAL HILLS DRIVE
Practice Address - Street 2:SUITE 390
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-796-8181
Practice Address - Fax:954-796-8191
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 59252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2556568004OtherCIGNA
FL12187OtherBLUE CROSS
FL293595OtherAVMED
FL005767OtherNEIGHBORHOOD HEALTHPLAN
FL107312OtherHUMANA
FL2556568004OtherCIGNA
FL12187OtherBLUE CROSS