Provider Demographics
NPI:1750436382
Name:FLEURINOR, JEAN RODRIGUEZ (MD)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:RODRIGUEZ
Last Name:FLEURINOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5827 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2000
Mailing Address - Country:US
Mailing Address - Phone:561-844-9443
Mailing Address - Fax:561-472-9692
Practice Address - Street 1:315 SOUTH WC OWEN
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3637
Practice Address - Country:US
Practice Address - Phone:863-983-7813
Practice Address - Fax:844-539-1104
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN221208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277491700Medicaid
FL173576Medicare UPIN
FL277491700Medicaid