Healthcare Provider Details

I. General information

NPI: 1619365269
Provider Name (Legal Business Name): MICHELLE J MEADOWS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2015
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 S CONGRESS AVE STE 204
ATLANTIS FL
33462-6637
US

IV. Provider business mailing address

5401 S CONGRESS AVE STE 204
ATLANTIS FL
33462-6637
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-4118
  • Fax: 561-967-3463
Mailing address:
  • Phone: 561-967-4118
  • Fax: 561-967-3463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9266024
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: