Healthcare Provider Details

I. General information

NPI: 1396594032
Provider Name (Legal Business Name): JULIE ANTOINE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 NW 33RD TER
COCONUT CREEK FL
33066-2252
US

IV. Provider business mailing address

2300 NW 33RD TER
COCONUT CREEK FL
33066-2252
US

V. Phone/Fax

Practice location:
  • Phone: 954-825-7798
  • Fax:
Mailing address:
  • Phone: 954-825-7798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11041098
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: