Provider Demographics
NPI:1013022375
Name:BOON, MICHAEL E (CNM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:BOON
Suffix:
Gender:M
Credentials:CNM
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Mailing Address - Street 1:770 NORTHPOINT PARKWAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-275-7604
Mailing Address - Fax:561-802-5385
Practice Address - Street 1:927 45TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2450
Practice Address - Country:US
Practice Address - Phone:561-881-5454
Practice Address - Fax:561-881-5559
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2017-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP1912032367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033678500Medicaid
FL033678500Medicaid