Provider Demographics
NPI:1265986335
Name:JEAN-LOUIS, RENAUD (ARNP/FNP/ PMHNP)
Entity type:Individual
Prefix:
First Name:RENAUD
Middle Name:
Last Name:JEAN-LOUIS
Suffix:
Gender:M
Credentials:ARNP/FNP/ PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2546
Mailing Address - Country:US
Mailing Address - Phone:786-285-9447
Mailing Address - Fax:954-922-3301
Practice Address - Street 1:2750 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2546
Practice Address - Country:US
Practice Address - Phone:786-285-9447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9351898363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty