Organization
INTERSTELLAR HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLINE LOUIS APRN (OWNER)
(954) 604-2227
Entity
Organization
Contact information
Practice address
980 N FEDERAL HWY STE 110, BOCA RATON, FL 33432-2704
(561) 247-1734
Mailing address
9374 AEGEAN DR, BOCA RATON, FL 33496-6681
(561) 206-2707
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/04/2022
Last updated
07/20/2022
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