Active NPI
Wandering Michelle, LLC
- Family Nurse Practitioner
- Fruitland Park, FL
National Provider Identifier
1114528874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- WANDERING MICHELLE, LLC
- Practice address
- 4208 Idlewild Dr
Fruitland Park, FL 34731-5638 - Phone
- (407) 920-0785
- Fax
- (352) 716-7611
- NPI assigned
- Nov 7, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle C Deflorimonte
- Title
- Owner
- Phone
- (407) 491-4478
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
4208 Idlewild Dr
Fruitland Park, FL 34731-5638
Mailing address
4208 Idlewild Dr
Fruitland Park, FL 34731-5638
Phone (407) 491-4478
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782172800000",
"number": "1114528874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4208 IDLEWILD DR",
"city": "FRUITLAND PARK",
"state": "FL",
"postal_code": "347315638",
"telephone_number": "407-491-4478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4208 IDLEWILD DR",
"city": "FRUITLAND PARK",
"state": "FL",
"postal_code": "347315638",
"telephone_number": "407-920-0785",
"fax_number": "352-716-7611"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WANDERING MICHELLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-11-07",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A",
"authorized_official_last_name": "DEFLORIMONTE",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "407-491-4478"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fruitland Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.