Provider Demographics
NPI:1730479387
Name:JUSINO, EDUARDO JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:JOSE
Last Name:JUSINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 VIA POINCIANA STE 8
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2991
Mailing Address - Country:US
Mailing Address - Phone:561-568-6463
Mailing Address - Fax:866-726-9519
Practice Address - Street 1:3918 VIA POINCIANA STE 8
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2991
Practice Address - Country:US
Practice Address - Phone:561-568-6463
Practice Address - Fax:866-726-9519
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 127978207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine