Healthcare Provider Details

I. General information

NPI: 1316135320
Provider Name (Legal Business Name): JEAN PAUL FONT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 12/03/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 SW 124TH AVE STE 312
MIAMI FL
33183-4634
US

IV. Provider business mailing address

8501 SW 124TH AVE STE 312
MIAMI FL
33183-4634
US

V. Phone/Fax

Practice location:
  • Phone: 305-485-7881
  • Fax: 305-485-7883
Mailing address:
  • Phone: 305-485-7881
  • Fax: 305-485-7883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberBP20023514
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD 2009-0205
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberME106115
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME106115
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: