Individual
CHANTALE LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14710 NE 9TH AVE, MIAMI, FL 33161-2316
(786) 290-2210
Mailing address
14710 NE 9TH AVE, MIAMI, FL 33161-2316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11000361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807041
—
FL
Enumeration date
07/27/2019
Last updated
07/27/2019
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