Individual
MR. CARL IVAN DENIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1150 NE 125TH ST, NORTH MIAMI, FL 33161-5019
(305) 403-0654
Mailing address
1150 NE 125TH ST, NORTH MIAMI, FL 33161-5019
(305) 403-0654
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9337095
FL
Other
Enumeration date
10/03/2017
Last updated
04/20/2020
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