Provider Demographics
NPI:1689637589
Name:JEAN BAPTISTE, JEAN ERNST
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ERNST
Last Name:JEAN BAPTISTE
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 1:12748 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5634
Mailing Address - Country:US
Mailing Address - Phone:239-437-5500
Mailing Address - Fax:239-437-5507
Practice Address - Street 1:12748 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5634
Practice Address - Country:US
Practice Address - Phone:239-464-8089
Practice Address - Fax:239-437-5507
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0091014208000000X, 2080P0204X
FLME910142080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271207500Medicaid