Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11000333 | FL |
NPI | 1023588175 |
---|---|
Provider Name | Mrs. Michelle Lakeman Chavoustie |
First Address | Miami Beach, FL 33139-5541 |
Second Address | Coral Gables, FL 33146-2008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2018 |
Last Update Date | 03/12/2018 |