| Doctor Name: | MS. ILYSSA MARIE PLANTADA |
| NPI Number: | 1043676117 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BC-FNP, ARNP |
| License Number: | ARNP9322146 |
| Business Practice Address: | 12411 Biscayne Blvd North Miami, FL - 331812520 |
| Business Phone Number: | 3056724222 |
| Business Fax Number: | |
| Mailing Address: | 12411 Biscayne Blvd, NORTH MIAMI |
| State: | FL |
| Postal Code: | 331812520 |
| Phone Number: | 3056724222 |
| Fax Number: | |
| NPI Enumeration Date: | 01/05/2016 |
| NPI Last Update Date: | 01/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9322146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |