MEDICARE: MDESARMES LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568079127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDESARMES LLC

Provider Business Mailing Address
First Line	:	6565 TAFT ST STE 406
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-4002
Country	:	US
Telephone Number	:	561-576-3074
Fax Number	:	561-557-7380

Provider Business Practice Location Address
First Line	:	6565 TAFT ST STE 406
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4002
Country	:	US
Telephone Number	:	561-576-3074
Fax Number	:	561-557-7380

Authorized Official
Title or Position	:	PROVIDER
Name	:	MICHELLE R DESARMES
Credential	:
Telephone Number	:	561-576-3074

Provider Enumeration Date	:	09/28/2020
Last Update Date	:	01/19/2026

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Directions to “MDESARMES LLC ” Practice Location

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