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General NPI Number Information
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NPI Number | 1730661158
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Entity Type | Individual
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Provider Name | MICHELLE ALEXIS ANAGNOSTU
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Gender | Female
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Dates
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Enumeration Date | 09/01/2018
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Last Update Date | 09/01/2018
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Provider Practice Location Address
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Address Line | 1447 MEDICAL PARK BLVD SUITE 406
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-795-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 252 GREENBRIER DRIVE
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City | PALM SPRINGS
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State | FL
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Zip | 33461
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Country | US
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Telephone | 561-756-2108
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Fax |
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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 | 9336938
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License Number State | FL
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