Healthcare Provider Details

I. General information

NPI: 1952989709
Provider Name (Legal Business Name): LUIDJI JEAN KERSAINT LOUISSAINT SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2071 W ATLANTIC BLVRD APT 102
POMPANO BEACH FL
33069
US

IV. Provider business mailing address

2071 W ATLANTIC BLVD APT 102
POMPANO BEACH FL
33069-2749
US

V. Phone/Fax

Practice location:
  • Phone: 954-699-6562
  • Fax:
Mailing address:
  • Phone: 954-699-6562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1209P.A.
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9055
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number147
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: