Provider Demographics
NPI:1659145761
Name:PIERRE-LOUIS, LUCSERNE (PA, DO)
Entity Type:Individual
Prefix:
First Name:LUCSERNE
Middle Name:
Last Name:PIERRE-LOUIS
Suffix:
Gender:M
Credentials:PA, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5771 S 38TH CT
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3236
Mailing Address - Country:US
Mailing Address - Phone:954-573-4203
Mailing Address - Fax:
Practice Address - Street 1:5771 S 38TH CT
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3236
Practice Address - Country:US
Practice Address - Phone:954-573-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001380-PA363AM0700X
IL001380363AM0700X
VT032.0134071TELE207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty