Individual
DR. JEAN-CLAUDE JEANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1275 W GRANADA BLVD, SUITE 3A, ORMOND BEACH, FL 32174-8259
(386) 672-1490
(386) 672-1682
Mailing address
1275 W GRANADA BLVD, SUITE 3A, ORMOND BEACH, FL 32174-8259
(386) 672-1490
(386) 672-1682
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0066990
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1202000
UNITED HEALTH CARE MEDICA
FL
01
—
14019
FLORIDA HOSPITAL HEALTH
FL
01
—
26333
BLUE CROSS
FL
05
—
2672715900
—
FL
01
—
5907098
AETNA
FL
01
—
6633914-001
CIGNA
FL
01
—
759373
CONNECTICARE
FL
01
—
761792
FIRST HEALTH
FL
Enumeration date
11/02/2005
Last updated
08/03/2011
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