Healthcare Provider Details

I. General information

NPI: 1972414233
Provider Name (Legal Business Name): EMILDA DESIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8424 NW 26TH PL
SUNRISE FL
33322-2918
US

IV. Provider business mailing address

8424 NW 26TH PL
SUNRISE FL
33322-2918
US

V. Phone/Fax

Practice location:
  • Phone: 954-638-4067
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number9608779
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: