Healthcare Provider Details

I. General information

NPI: 1841107935
Provider Name (Legal Business Name): SHAQUEENA PARMELA LOUIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2949 SW SKYLINE ST
PORT SAINT LUCIE FL
34953-3342
US

IV. Provider business mailing address

2949 SW SKYLINE ST
PORT SAINT LUCIE FL
34953-3342
US

V. Phone/Fax

Practice location:
  • Phone: 772-646-1351
  • Fax: 772-646-1351
Mailing address:
  • Phone: 772-646-1351
  • Fax: 772-646-1351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAQUEENA PARMELA LOUIS
Title or Position: OWNER AND ADMINISTRATOR
Credential:
Phone: 772-646-1351