| Louis B Antoine Md Faap Pa | |
|
4801 S University Dr Suite 239 Davie FL 33328-3839 | |
| (954) 249-1984 | |
| (954) 434-8711 |
| Full Name | Louis B Antoine Md Faap Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4801 S University Dr, Davie, Florida |
| Authorized Official Name and Position | Louis B Antoine (PRESIDENT) |
| Authorized Official Contact | 9542491984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis B Antoine Md Faap Pa 11979 Sw 55 Street Cooper City FL 33330-3310 Ph: (954) 249-1984 | Louis B Antoine Md Faap Pa 4801 S University Dr Suite 239 Davie FL 33328-3839 Ph: (954) 249-1984 |
| NPI Number | 1699114447 |
|---|---|
| Provider Enumeration Date | 06/14/2013 |
| Last Update Date | 06/14/2013 |
| Medicare PECOS PAC ID | 4981843802 |
|---|---|
| Medicare Enrollment ID | O20130625000268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699114447 | NPI | - | NPPES |
| 006682800 | Medicaid | FL | |
| 34012 | Other | FL | BC BS FLORIDA |
| ME45466 | Other | FL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME45466 (Florida) | Primary |
| Provider Name | Louis B Antoine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700890555 PECOS PAC ID: 1951540871 Enrollment ID: I20130625000301 |
| Provider Name | Claudette Premice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962089011 PECOS PAC ID: 6204237472 Enrollment ID: I20210624003193 |
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