Individual
MR. PHILIPPE LOUIS-JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
671 NW 119 STREET, NORTH MIAMI, FL 33168
(305) 688-0811
(305) 688-6304
Mailing address
2706 ISLAND DR, MIRAMAR, FL 33023-4606
(954) 338-5236
(954) 338-5236
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103385
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001126500
—
FL
Enumeration date
11/23/2007
Last updated
04/16/2012
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