Provider Demographics
NPI:1598152480
Name:PHILIPPE, MARTINE
Entity Type:Individual
Prefix:
First Name:MARTINE
Middle Name:
Last Name:PHILIPPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12293 COLONY PRESERVE DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-5807
Mailing Address - Country:US
Mailing Address - Phone:561-396-0108
Mailing Address - Fax:
Practice Address - Street 1:12293 COLONY PRESERVE DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-5807
Practice Address - Country:US
Practice Address - Phone:561-396-0108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-19
Last Update Date:2015-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator