Javan Ettiene

NPI # 

Practice Address:

7904 Lasalle Blvd

Miramar, FL, 33023-4500

Practice Phone:

954-934-4265

License Number:

APRN11013397

License State:

FL

Taxonomy Grouping:

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy Classification:

Nurse Practitioner

Taxonomy Specialization:

Psychiatric/Mental Health

Taxonomy Code:

363LP0808X

Updated by NPPES on 6/11/2021. You can view the original data set for NPI # 1174197164 on the official NPPES website. If the information about this NPI provider/company is outdated you can request updates through the NPPES website. See our FAQ page for more information.

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