Basic Information
| Provider Information | |||||||||
| NPI: | 1619572310 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JEAN PIERRE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1361 E IRLO BRONSON MEMORIAL HWY | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347715823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079571454 | ||||||||
| FaxNumber: | 4079571706 | ||||||||
| Practice Location | |||||||||
| Address1: | 1361 E. IRLO BRONSON MEMORIAL HWY. | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079571454 | ||||||||
| FaxNumber: | 4079571706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2020 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 30480 | FL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 225200000X | 30480 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.