Provider Demographics
NPI:1689158800
Name:LOUIDOR, GINOU (ARNP)
Entity Type:Individual
Prefix:
First Name:GINOU
Middle Name:
Last Name:LOUIDOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3334
Mailing Address - Country:US
Mailing Address - Phone:561-351-1295
Mailing Address - Fax:
Practice Address - Street 1:517 CYPRESS DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3334
Practice Address - Country:US
Practice Address - Phone:561-351-1295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9266054363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily