Healthcare Provider Details

I. General information

NPI: 1174439087
Provider Name (Legal Business Name): JN LOUIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW PRIMA VISTA BLVD
PORT SAINT LUCIE FL
34986
US

IV. Provider business mailing address

5716 NW ALCAZAR TER
PORT SAINT LUCIE FL
34986-3546
US

V. Phone/Fax

Practice location:
  • Phone: 786-541-4755
  • Fax:
Mailing address:
  • Phone: 786-541-4755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State

VIII. Authorized Official

Name: EMMANUELLE JN LOUIS
Title or Position: MANAGER
Credential: RN
Phone: 786-541-4755