Healthcare Provider Details

I. General information

NPI: 1508048158
Provider Name (Legal Business Name): JEAN-PIERRE STEPHAN AWAIDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5162 LINTON BLVD STE 102
DELRAY BEACH FL
33484-6567
US

IV. Provider business mailing address

5162 LINTON BLVD STE 102
DELRAY BEACH FL
33484-6567
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-3919
  • Fax:
Mailing address:
  • Phone: 561-499-3919
  • Fax: 561-499-4338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number01056048A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME101406
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number2008003418
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: