Healthcare Provider Details

I. General information

NPI: 1720914351
Provider Name (Legal Business Name): JOSEPH DESULME FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 NE 1ST AVE
CAPE CORAL FL
33909-1912
US

IV. Provider business mailing address

628 NE 1ST AVE
CAPE CORAL FL
33909-1912
US

V. Phone/Fax

Practice location:
  • Phone: 561-672-5007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPTP.N3.70147717
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: