Provider Demographics
NPI:1982179057
Name:DESGRAVES, FLORENCE ALEXANDRE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:ALEXANDRE
Last Name:DESGRAVES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:FLORENCE
Other - Middle Name:ALEXANDRE
Other - Last Name:DESGRAVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:8654 S LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2539
Mailing Address - Country:US
Mailing Address - Phone:954-651-1588
Mailing Address - Fax:
Practice Address - Street 1:4000 HOLLYWOOD BLVD STE 715S
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6755
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001038363LP0808X, 363LF0000X
FL11001038163WP0808X
FL9251097163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse