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General NPI Number Information
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NPI Number | 1952271108
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Entity Type | Individual
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Provider Name | JOHANNA MICHELLE DESANTIS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 13901 US HIGHWAY 1 STE 5
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City | JUNO BEACH
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State | FL
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Zip | 33408-1612
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Country | US
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Telephone | 561-491-4666
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Fax |
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Provider Business Mailing Address
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Address Line | 10101 OAK BARK LN
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-5130
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Country | US
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Telephone | 561-601-7150
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F11250057
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License Number State | FL
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