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General NPI Number Information
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NPI Number | 1336803345
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Entity Type | Individual
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Provider Name | WISLY JEAN BAPTISTE
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Gender | Male
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 1827 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1442
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Country | US
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Telephone | 954-800-4054
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Fax | 954-654-7732
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Provider Business Mailing Address
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Address Line | 1827 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1442
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Country | US
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Telephone | 954-800-4054
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Fax | 954-654-7732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11016139
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License Number State | FL
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