Provider Demographics
NPI:1437040466
Name:PIERRE LOUIS, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:PIERRE LOUIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4524
Mailing Address - Country:US
Mailing Address - Phone:954-624-5563
Mailing Address - Fax:
Practice Address - Street 1:5757 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4135
Practice Address - Country:US
Practice Address - Phone:954-463-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP003430363LP0808X
CA95035135363LP0808X
FLAPRN11037292363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty