Healthcare Provider Details
I. General information
NPI: 1144766619
Provider Name (Legal Business Name): SOPHIA GISCOMBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/09/2017
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
840 US HIGHWAY 1 STE 120
NORTH PALM BEACH FL
33408-3858
US
IV. Provider business mailing address
2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US
V. Phone/Fax
- Phone: 561-776-7300
- Fax: 561-776-8727
- Phone: 561-432-5849
- Fax: 561-283-0677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | ARNP9338099 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: