Individual provider Active NPI

Annuel Lebrun

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1962031633
Registry record updated Apr 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NJDCATEM-000456 Issued in NJ
Practice address
5317 Curry Ford Rd Apt K202
Orlando, FL 32812-7209
Phone
(678) 548-1536
NPI assigned
Apr 5, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NJDCATEM-000456 NJ Primary

Addresses

Primary practice location

5317 Curry Ford Rd Apt K202
Orlando, FL 32812-7209

Mailing address

5317 Curry Ford Rd Apt K202
Orlando, FL 32812-7209
Phone (678) 548-1536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220622003004 FL Practitioner - Nurse Practitioner 9436538360 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NJDCATEM-000456NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc Family Medicine CurrentSince Jun 7, 2022 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1962031633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 CURRY FORD RD APT K202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328127209",
            "telephone_number": "678-548-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 CURRY FORD RD APT K202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328127209",
            "telephone_number": "678-548-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRUN",
        "first_name": "ANNUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-05",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "NJDCATEM-000456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.