Individual
LUDGY RENAUD SUPPLICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11261 SW 164TH TER, MIAMI, FL 33157-2717
(786) 543-3081
Mailing address
11261 SW 164TH TER, MIAMI, FL 33157-2717
(786) 543-3081
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9265816
FL
363LP2300X
Primary Care Nurse Practitioner
9265816
FL
Other
Enumeration date
08/29/2018
Last updated
12/14/2023
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