Dr. Lesly Jean MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

45032 Issued in FL

Legal business name

DR. LESLY JEAN MD PA

Practice address

321 W Atlantic Blvd
Ste 102
Pompano Beach, FL 33060-6048

Phone

(954) 781-3122

Fax

(954) 781-0860

NPI assigned

Mar 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Philana Robinson Davis

Title

Medical Assistant

Phone

(954) 781-3122

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1386918621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W ATLANTIC BLVD",
            "address_2": "STE 102",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330606048",
            "telephone_number": "954-781-3122",
            "fax_number": "954-781-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W ATLANTIC BLVD",
            "address_2": "STE 102",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330606048",
            "telephone_number": "954-781-3122",
            "fax_number": "954-781-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LESLY JEAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "PHILANA",
        "authorized_official_middle_name": "ROBINSON",
        "authorized_official_title_or_position": "MEDICAL ASSISTANT",
        "authorized_official_telephone_number": "954-781-3122",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "45032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061521800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE I.D.",
            "identifier": "07927",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.