Provider Demographics
NPI:1205030855
Name:CARON, JEAN S (DOM, AP, LMT)
Entity type:Individual
Prefix:MR
First Name:JEAN
Middle Name:S
Last Name:CARON
Suffix:
Gender:M
Credentials:DOM, AP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 2ND ST STE 302
Mailing Address - Street 2:
Mailing Address - City:HOLLY HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4903
Mailing Address - Country:US
Mailing Address - Phone:386-677-5400
Mailing Address - Fax:386-347-5420
Practice Address - Street 1:101 2ND ST STE 302
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:FL
Practice Address - Zip Code:32117-4903
Practice Address - Country:US
Practice Address - Phone:386-677-5400
Practice Address - Fax:386-347-5420
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2427171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist