JAVAN ETTIENE
NPI 1174197164
Nurse Practitioner - Psychiatric/Mental Health in Miramar, FL

Q: What is Javan Ettiene's NPI number?

The NPI number for Javan Ettiene is 1174197164. It was assigned to this individual provider in the NPPES registry on May 14, 2021.

Q: What is Javan Ettiene's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Javan Ettiene was last updated on June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 14, 2021

7904 LASALLE BLVD, MIRAMAR, FL 33023(954) 934-4265 Get Directions Write a Review

NPPES record last updated: June 11, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 11, 2021, May 14, 2021 (2 updates tracked since 2021).

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About Javan Ettiene NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAVAN ETTIENE (NPI 1174197164) is an individual psychiatric/mental health provider in Miramar, Florida, licensed in Florida (APRN11013397) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1174197164

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameJAVAN ETTIENE

Location Address7904 LASALLE BLVDMiramar, FL 33023-4500

Mailing Address7904 Lasalle BlvdMiramar, FL 33023-4500 · (954) 934-4265

Phone(954) 934-4265

Sole ProprietorYes

Enumeration DateMay 14, 2021

Last NPPES UpdateJune 11, 20212 updates tracked since enumeration

NPPES CertifiedJune 11, 2021

✔ NPI 1174197164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in FL · APRN11013397

7904 LASALLE BLVD, Miramar, FL 33023

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Javan Ettiene's NPI number?

The NPI number for Javan Ettiene is 1174197164. It was assigned to this individual provider in the NPPES registry on May 14, 2021.

Where is Javan Ettiene located?

Javan Ettiene practices at 7904 Lasalle Blvd, Miramar, FL 33023. The listed phone number is (954) 934-4265.

What is Javan Ettiene's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Javan Ettiene was last updated on June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.