Healthcare Provider Details

I. General information

NPI: 1154827384
Provider Name (Legal Business Name): CARLINE JEAN-PHILIPPE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NW 13TH ST FL 3
BOCA RATON FL
33486-2305
US

IV. Provider business mailing address

701 NW 13TH ST FL 3
BOCA RATON FL
33486-2305
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-6129
  • Fax: 561-955-5791
Mailing address:
  • Phone: 561-955-6129
  • Fax: 561-955-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10038250NP-PP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9345892
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9345892
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: