Healthcare Provider Details

I. General information

NPI: 1427836212
Provider Name (Legal Business Name): MYRTHA LOUIS MSN,APRN ,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 04/29/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10111 FOREST HILL BLVD SUITE 320
WELLINGTON FL
33414
US

IV. Provider business mailing address

10111 FOREST HILL BLVD SUITE 320
WELLINGTON FL
33414-6142
US

V. Phone/Fax

Practice location:
  • Phone: 561-623-0801
  • Fax: 561-469-1928
Mailing address:
  • Phone: 561-623-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11028730
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: