MEDICARE: MATHILDE LOUIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282E00000X	Long Term Care Hospital	RT9180	FL

General Provider Information

NPI Number	:	1194960526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATHILDE LOUIS

Provider Business Mailing Address
First Line	:	8410 NE 2ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3928
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8410 NE 2CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3928
Country	:	US
Telephone Number	:	305-490-1304
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED RESPIRATORY THERAPY
Name	:	MS. MATHILDE LOUIS
Credential	:
Telephone Number	:	305-490-1304

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	12/15/2008

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