Provider Demographics
NPI:1780005397
Name:FORTE, JEAN-MARCEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JEAN-MARCEL
Middle Name:
Last Name:FORTE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:W
Other - Last Name:MOSKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11500 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-2506
Mailing Address - Country:US
Mailing Address - Phone:305-751-1500
Mailing Address - Fax:305-751-1507
Practice Address - Street 1:11500 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2506
Practice Address - Country:US
Practice Address - Phone:305-751-1500
Practice Address - Fax:305-751-1507
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107467363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical