Provider Demographics
NPI:1699142182
Name:PIERRE- JEUNE, MARCLEENDA
Entity type:Individual
Prefix:
First Name:MARCLEENDA
Middle Name:
Last Name:PIERRE- JEUNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:N/A
Mailing Address - Street 1:6128 LOST TREE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-4255
Mailing Address - Country:US
Mailing Address - Phone:407-283-0885
Mailing Address - Fax:
Practice Address - Street 1:6128 LOST TREE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-4255
Practice Address - Country:US
Practice Address - Phone:407-283-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Yes251E00000XAgenciesHome Health