Healthcare Provider Details

I. General information

NPI: 1215576947
Provider Name (Legal Business Name): ISLANDE PHILIPPE MICHEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 BURNS RD STE 306
PALM BEACH GARDENS FL
33410-4357
US

IV. Provider business mailing address

876 QUARTZ TER
WEST PALM BEACH FL
33413-1200
US

V. Phone/Fax

Practice location:
  • Phone: 561-630-8775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11005509
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: