Provider Demographics
NPI:1326662370
Name:LOUIS, JAMES (PERNSANAL CARE)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LOUIS
Suffix:
Gender:M
Credentials:PERNSANAL CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 NE 207TH LN APT 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1980
Mailing Address - Country:US
Mailing Address - Phone:305-763-7483
Mailing Address - Fax:
Practice Address - Street 1:500 NW 165TH STREET RD STE 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6306
Practice Address - Country:US
Practice Address - Phone:786-580-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care