Provider Demographics
NPI:1154574762
Name:GERMAIN, JEAN (RRT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:GERMAIN
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 W MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34981-4956
Mailing Address - Country:US
Mailing Address - Phone:772-462-6601
Mailing Address - Fax:772-462-6634
Practice Address - Street 1:2959 W MIDWAY RD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981-4956
Practice Address - Country:US
Practice Address - Phone:772-462-6601
Practice Address - Fax:772-462-6634
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT70542279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRT7054OtherRESPIRATORY THERAPIST