Provider Demographics
NPI:1962691980
Name:FONTAINE, ISABELLE FRANCE (PT)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:FRANCE
Last Name:FONTAINE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7934
Mailing Address - Country:US
Mailing Address - Phone:561-737-7733
Mailing Address - Fax:561-735-7036
Practice Address - Street 1:5311 GRAND BANKS BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-5949
Practice Address - Country:US
Practice Address - Phone:561-649-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT14566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist