Healthcare Provider Details

I. General information

NPI: 1902731292
Provider Name (Legal Business Name): PRESELENE LOUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 W MCNAB RD
NORTH LAUDERDALE FL
33068-4303
US

IV. Provider business mailing address

7900 W MCNAB RD
NORTH LAUDERDALE FL
33068-4303
US

V. Phone/Fax

Practice location:
  • Phone: 754-265-6498
  • Fax:
Mailing address:
  • Phone: 754-265-6498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO8404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: