Healthcare Provider Details

I. General information

NPI: 1003746124
Provider Name (Legal Business Name): CARL EDWIN PIERRELOUIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S MILITARY TRL
DEERFIELD BEACH FL
33442-7687
US

IV. Provider business mailing address

1325 S MILITARY TRL
DEERFIELD BEACH FL
33442-7687
US

V. Phone/Fax

Practice location:
  • Phone: 954-428-7406
  • Fax: 954-421-5963
Mailing address:
  • Phone: 954-428-7406
  • Fax: 954-421-5963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPSI43944
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: