Healthcare Provider Details

I. General information

NPI: 1124789615
Provider Name (Legal Business Name): ALTHEA CAROLINE WILMOT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 45TH ST
WEST PALM BEACH FL
33407-2361
US

IV. Provider business mailing address

1515 N FLAGLER DR STE 101
WEST PALM BEACH FL
33401-3429
US

V. Phone/Fax

Practice location:
  • Phone: 561-642-1000
  • Fax: 561-804-5629
Mailing address:
  • Phone: 561-642-1000
  • Fax: 561-804-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017137
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: