MEDICARE: WELLSCARE SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1477127090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSCARE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	4379 LAKE TAHOE CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-7872
Country	:	US
Telephone Number	:	561-254-9769
Fax Number	:	707-240-0168

Provider Business Practice Location Address
First Line	:	4379 LAKE TAHOE CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-7872
Country	:	US
Telephone Number	:	561-254-9769
Fax Number	:	707-240-0168

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	JUDY-ANN S WELLINGTON
Credential	:	NP
Telephone Number	:	561-254-9769

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	05/18/2021

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