MEDICARE: IRMA JEAN LOUIS CNA

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	374U00000X	Home Health Aide		FL

General Provider Information

NPI Number	:	1962972562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRMA JEAN LOUIS CNA

Provider Business Mailing Address
First Line	:	6885 COLLEGE CT APT 203
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33317-7164
Country	:	US
Telephone Number	:	954-394-9218
Fax Number	:	954-999-0522

Provider Business Practice Location Address
First Line	:	6885 COLLEGE CT APT 203
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33317-7164
Country	:	US
Telephone Number	:	954-394-9218
Fax Number	:	954-999-0522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2018
Last Update Date	:	11/27/2018

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Directions to “ IRMA JEAN LOUIS CNA” Practice Location

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