Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Javan Ettiene

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1174197164

Javan Ettiene is a Psychiatric/Mental Health Nurse Practitioner in Miramar, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2021

Practice location Address checks out

7904 Lasalle Blvd
Miramar, FL 33023-4500
Phone: (954) 934-4265
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APRN11013397 (FL)

Record details

NPI number1174197164
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 14, 2021
Last updated in NPPESJune 11, 2021
Certification dateJune 11, 2021
Mailing address7904 Lasalle Blvd, Miramar, FL 33023-4500

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