Provider Demographics
NPI:1528707783
Name:JEAN-BAPTISTE, FLORTILE (NP)
Entity type:Individual
Prefix:
First Name:FLORTILE
Middle Name:
Last Name:JEAN-BAPTISTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 W BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5005
Mailing Address - Country:US
Mailing Address - Phone:813-681-5702
Mailing Address - Fax:813-653-2376
Practice Address - Street 1:621 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5005
Practice Address - Country:US
Practice Address - Phone:812-681-5702
Practice Address - Fax:813-653-2376
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019917363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily