Individual
LOUIS PROFETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 N BONITA AVE, PANAMA CITY, FL 32401-3623
(850) 769-1511
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01041413
IN
207P00000X
Emergency Medicine Physician
Primary
ME164638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100338950
—
IN
Enumeration date
10/03/2006
Last updated
01/26/2026
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