Provider Demographics
NPI:1427797380
Name:MERVIL, FLORANTE
Entity type:Individual
Prefix:MRS
First Name:FLORANTE
Middle Name:
Last Name:MERVIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLORANTE
Other - Middle Name:MARIE
Other - Last Name:PIERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 SNAPDRAGON WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-6388
Mailing Address - Country:US
Mailing Address - Phone:904-206-6918
Mailing Address - Fax:
Practice Address - Street 1:770 53RD ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1814
Practice Address - Country:US
Practice Address - Phone:510-428-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program