Provider Demographics
NPI:1669064762
Name:SUFFRIN, JEAN FLOBERT
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:FLOBERT
Last Name:SUFFRIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9752 NW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8603
Mailing Address - Country:US
Mailing Address - Phone:954-594-2372
Mailing Address - Fax:
Practice Address - Street 1:9752 NW 37TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8603
Practice Address - Country:US
Practice Address - Phone:954-594-2372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010832207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine