Milange Deristile, BSW

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931

Phone

(561) 616-8411

NPI assigned

Feb 22, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1013257328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 19TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334075710",
            "telephone_number": "203-802-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065931",
            "telephone_number": "561-616-8411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1803 N Jog Rd",
            "address_2": "apt 103",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334112526",
            "country_code": "US",
            "telephone_number": "919-696-0452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERISTILE",
        "first_name": "MILANGE",
        "credential": "BSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.