Provider Demographics
NPI:1780644385
Name:LABISSIERE, JEAN CLAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN CLAUDE
Middle Name:
Last Name:LABISSIERE
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 1:555 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3469
Mailing Address - Country:US
Mailing Address - Phone:561-739-9333
Mailing Address - Fax:561-739-9911
Practice Address - Street 1:555 NORTH CONGRESS AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8612
Practice Address - Country:US
Practice Address - Phone:561-739-9333
Practice Address - Fax:561-739-9911
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94972207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002491100Medicaid
FL1780644385Medicare PIN
FL002491100Medicaid