Provider Demographics
NPI:1063926632
Name:SAINTVIL, JEAN DENIS (SPEECH THERAPIST-CF)
Entity type:Individual
Prefix:MR
First Name:JEAN DENIS
Middle Name:
Last Name:SAINTVIL
Suffix:
Gender:M
Credentials:SPEECH THERAPIST-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 SW 19TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5688
Mailing Address - Country:US
Mailing Address - Phone:407-757-3454
Mailing Address - Fax:
Practice Address - Street 1:587 SE ERMINE AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6126
Practice Address - Country:US
Practice Address - Phone:386-752-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-18
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010868235Z00000X
FLSZ8338235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist