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Organization

JEAN, EZECHIEL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EZECHIEL JEAN (ADMINISTRATOR)
(561) 513-7382
Entity
Organization

Contact information

Practice address
51 ALEGRO DR, SOUTHPORT, FL 32409-1745
(561) 513-7382
(850) 257-8096
Mailing address
51 ALEGRO DR, SOUTHPORT, FL 32409-1745
(561) 513-7382
(850) 257-8096

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
01/28/2026
Last updated
01/29/2026
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