Provider Demographics
NPI:1184482416
Name:PIERRE-LOUIS PROVIDER SERVICES LLC
Entity type:Organization
Organization Name:PIERRE-LOUIS PROVIDER SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:PIERRE-LOUIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-361-0682
Mailing Address - Street 1:2468 ANNACELLA AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7956
Mailing Address - Country:US
Mailing Address - Phone:407-361-0682
Mailing Address - Fax:
Practice Address - Street 1:14050 TOWN LOOP BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6190
Practice Address - Country:US
Practice Address - Phone:407-361-0682
Practice Address - Fax:407-210-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty