Healthcare Provider Details

I. General information

NPI: 1821251216
Provider Name (Legal Business Name): JEAN-PAUL AZZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4495 MILITARY TRL STE 202 THE PALM BEACH CENTER FOR FACIAL PLASTIC AND LASER SURG
JUPITER FL
33458-4818
US

IV. Provider business mailing address

8168 SE PILOTS COVE TER
HOBE SOUND FL
33455-3929
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-6277
  • Fax:
Mailing address:
  • Phone: 352-871-1015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberME117560
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: