Individual
LOUIS CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1150 N 35TH AVE STE 440, HOLLYWOOD, FL 33021-5430
(954) 987-2020
(954) 987-2953
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2315
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291116700
—
FL
Enumeration date
08/13/2006
Last updated
03/18/2021
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