Healthcare Provider Details

I. General information

NPI: 1386934511
Provider Name (Legal Business Name): MARIE MAGDALA BISSAINTHE REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12713 PATTERSON CLUB DR APT 10302
ORLANDO FL
32821-6724
US

IV. Provider business mailing address

12713 PATTERSON CLUB DR APT 10302
ORLANDO FL
32821-6724
US

V. Phone/Fax

Practice location:
  • Phone: 786-226-5049
  • Fax:
Mailing address:
  • Phone: 786-226-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9631793
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: