MEDICARE: FLAVIE E JEAN-GILLES CRT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227800000X	Certified Respiratory Therapist	TT15050	FL

General Provider Information

NPI Number	:	1578084729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLAVIE E JEAN-GILLES CRT

Provider Business Mailing Address
First Line	:	1840 W 49TH ST STE 603
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2887
Country	:	US
Telephone Number	:	305-389-3027
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 W 49TH ST STE 603
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2887
Country	:	US
Telephone Number	:	305-389-3027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	07/21/2022

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