Healthcare Provider Details

I. General information

NPI: 1629980610
Provider Name (Legal Business Name): CHANTAL DESIR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 W BROWARD BLVD
PLANTATION FL
33317-3708
US

IV. Provider business mailing address

4450 W BROWARD BLVD
PLANTATION FL
33317-3708
US

V. Phone/Fax

Practice location:
  • Phone: 954-651-4108
  • Fax:
Mailing address:
  • Phone: 954-651-4108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3235302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: