Provider Demographics
NPI:1306217690
Name:JEAN-BAPTISTE, RUBENS
Entity type:Individual
Prefix:
First Name:RUBENS
Middle Name:
Last Name:JEAN-BAPTISTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 RIDGEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4130
Mailing Address - Country:US
Mailing Address - Phone:954-865-0001
Mailing Address - Fax:407-386-3164
Practice Address - Street 1:6422 RIDGEBERRY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4130
Practice Address - Country:US
Practice Address - Phone:954-865-0001
Practice Address - Fax:407-386-3164
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9310398363LF0000X
FLAPRN9310398363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty