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General NPI Number Information
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NPI Number | 1336518208
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Entity Type | Individual
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Provider Name | FARRAH SAINT- LOUIS LUC FNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 5149 S UNIVERSITY DR
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City | DAVIE
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State | FL
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Zip | 33328-4507
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Country | US
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Telephone | 954-434-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 NW 76TH AVE
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City | PLANTATION
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State | FL
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Zip | 33322-5143
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Country | US
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Telephone | 305-794-7139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9304005
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License Number State | FL
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