Individual
DR. WILDA B BEAUVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DR.
Contact information
Practice address
6453 PEMBROKE RD, HOLLYWOOD, FL 33023-2137
(954) 559-4066
Mailing address
6453 PEMBROKE RD FL 33025, HOLLYWOOD, FL 33023-2137
(954) 859-6294
(954) 859-6152
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN9435744
FL
376G00000X
Nursing Home Administrator
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-1548904
—
FL
Enumeration date
06/14/2019
Last updated
12/13/2024
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