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Individual

EZECHIEL JEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

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
6907145
FL

Other

Enumeration date
08/27/2025
Last updated
08/27/2025
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