Individual provider · Type 1 NPI

Nicole Louis, PHYSICIAN ASSISTANT

Medical Physician Assistant · Mangonia Park, FL

NPI number 1912467598 Active

Practice location

901 45th St
Mangonia Park, FL 33407-2413

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Other practice locations

  • 3375 Burns Rd Ste 206, Palm Beach Gardens, FL 33410-4361 · (561) 799-9559
  • 3401 N Broad St, Philadelphia, PA 19140-5103 · (215) 707-1622

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X9112025 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1912467598

Nicole Louis, PHYSICIAN ASSISTANT's National Provider Identifier is 1912467598, issued on Mar 21, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Mangonia Park, FL. The record was last updated on Sep 25, 2026.