MEDICARE: MS. ESMEWALDA D LOUIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN.481055	OH

General Provider Information

NPI Number	:	1316546427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ESMEWALDA D LOUIS

Provider Business Mailing Address
First Line	:	9811 SW 13TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-3601
Country	:	US
Telephone Number	:	954-647-9473
Fax Number	:

Provider Business Practice Location Address
First Line	:	6453 PEMBROKE RD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-2137
Country	:	US
Telephone Number	:	954-647-9473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	10/20/2020

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