Provider Demographics
NPI:1790336972
Name:PIERRE-LOUIS, HEROLD (MD)
Entity type:Individual
Prefix:
First Name:HEROLD
Middle Name:
Last Name:PIERRE-LOUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 W US HIGHWAY 90 STE 130
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-3740
Mailing Address - Country:US
Mailing Address - Phone:386-487-6357
Mailing Address - Fax:
Practice Address - Street 1:1037 W US HIGHWAY 90 STE 130
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-3740
Practice Address - Country:US
Practice Address - Phone:864-876-3573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1700208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice