Provider Demographics
NPI:1427740182
Name:JEAN-BART, VLADIMIR CARL
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:CARL
Last Name:JEAN-BART
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 1:13220 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4133
Mailing Address - Country:US
Mailing Address - Phone:305-780-1945
Mailing Address - Fax:
Practice Address - Street 1:13220 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4133
Practice Address - Country:US
Practice Address - Phone:305-780-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient