Provider Demographics
NPI:1447911003
Name:JEAN-LOUIS, LUK-OLIVIER (FNP-C)
Entity type:Individual
Prefix:MR
First Name:LUK-OLIVIER
Middle Name:
Last Name:JEAN-LOUIS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:MR
Other - First Name:LUK-OLIVIER
Other - Middle Name:
Other - Last Name:JEAN-LOUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1751 BONAVENTURE BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4039
Mailing Address - Country:US
Mailing Address - Phone:888-689-8648
Mailing Address - Fax:954-656-3188
Practice Address - Street 1:1751 BONAVENTURE BLVD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4039
Practice Address - Country:US
Practice Address - Phone:888-689-8648
Practice Address - Fax:954-656-3188
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11017311363LF0000X
FLAPRN11017311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty