Healthcare Provider Details

I. General information

NPI: 1003632555
Provider Name (Legal Business Name): METUCHELA PIERRE CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 NE 8TH AVE
OAKLAND PARK FL
33334-3215
US

IV. Provider business mailing address

5023 SOCIETY PL E APT E
WEST PALM BEACH FL
33415-3778
US

V. Phone/Fax

Practice location:
  • Phone: 954-547-7180
  • Fax: 954-533-9367
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: