MEDICARE: ISLANDE PHILIPPE MICHEL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	11005509	FL

General Provider Information

NPI Number	:	1215576947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISLANDE PHILIPPE MICHEL APRN

Provider Business Mailing Address
First Line	:	876 QUARTZ TER
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 BURNS RD STE 306
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4357
Country	:	US
Telephone Number	:	561-630-8775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2019
Last Update Date	:	06/01/2026

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