Provider Demographics
NPI:1851898936
Name:EDUARDO JUSINO MD LLC
Entity Type:Organization
Organization Name:EDUARDO JUSINO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-457-1713
Mailing Address - Street 1:9835 LAKE WORTH RD # 16-235
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2300
Mailing Address - Country:US
Mailing Address - Phone:787-457-1713
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127978207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty