Provider Demographics
NPI:1760285951
Name:LOUIDOR, MAILUCE
Entity type:Individual
Prefix:
First Name:MAILUCE
Middle Name:
Last Name:LOUIDOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12049 PIONEERS WAY APT 2308
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-2814
Mailing Address - Country:US
Mailing Address - Phone:561-414-7532
Mailing Address - Fax:
Practice Address - Street 1:12049 PIONEERS WAY APT 2308
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-2814
Practice Address - Country:US
Practice Address - Phone:561-414-7532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038510363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health