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NPI Code Detail

MEDICARE: WILLY CLERISIER NURSE PRACTITIONER

MEDICARE: WILLY CLERISIER NURSE PRACTITIONER
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
1363LA2200XAdult Health Nurse Practitioner9428225FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518478650
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLY CLERISIER NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 6980 SW 1ST ST
Second Line :
City : MARGATE
State : FL
Zip : 33068-1645
Country : US
Telephone Number : 954-534-6681
Fax Number :
Provider Business Practice Location Address
First Line : 650 NW 120TH ST
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33168-2529
Country : US
Telephone Number : 305-688-0811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2017
Last Update Date : 09/08/2020

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