Individual
JAVAN ETTIENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7904 LASALLE BLVD, MIRAMAR, FL 33023-4500
(954) 934-4265
Mailing address
7904 LASALLE BLVD, MIRAMAR, FL 33023-4500
(954) 934-4265
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11013397
FL
Other
Enumeration date
05/14/2021
Last updated
06/11/2021
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