Healthcare Provider Details

I. General information

NPI: 1629203245
Provider Name (Legal Business Name): STEVENS PIERRE LOUIS BS-RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NE 44TH ST
POMPANO BEACH FL
33064-4116
US

IV. Provider business mailing address

400 NE 44TH ST
POMPANO BEACH FL
33064-4116
US

V. Phone/Fax

Practice location:
  • Phone: 954-812-3747
  • Fax:
Mailing address:
  • Phone: 954-812-3747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License NumberRT 9332
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2279P3900X
TaxonomyNeonatal/Pediatric Registered Respiratory Therapist
License NumberRT 9332
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberRT9332
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: