| Doctor Name: | LOIUS CARLISLE |
| NPI Number: | 1023020310 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA2315 |
| Business Practice Address: | 3501 Johnson St Hollywood, FL - 330215421 |
| Business Phone Number: | 9549872020 |
| Business Fax Number: | |
| Mailing Address: | Po Box 862233, ORLANDO |
| State: | FL |
| Postal Code: | 328862233 |
| Phone Number: | 9542765575 |
| Fax Number: | 9543022813 |
| NPI Enumeration Date: | 08/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA2315 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |