Individual provider Active NPI

Jodyon Fieulleteau, PROSTHETIC SPECIALIS

  • Customized Equipment (DME)
  • Lake Mary, FL
National Provider Identifier
1467042366
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Practice address
2513 Lobelia Dr
Lake Mary, FL 32746-2680
Phone
(973) 901-5860
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X FL
Prosthetic/Orthotic Supplier 335E00000X FL
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

2513 Lobelia Dr
Lake Mary, FL 32746-2680

Mailing address

2513 Lobelia Dr
Lake Mary, FL 32746-2680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1467042366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 LOBELIA DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 LOBELIA DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462680",
            "telephone_number": "973-901-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEULLETEAU",
        "first_name": "JODYON",
        "credential": "PROSTHETIC SPECIALIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.