Healthcare Provider Details

I. General information

NPI: 1356940431
Provider Name (Legal Business Name): DR. KATINA HEALTH AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 CORAL HILLS DR STE 330
CORAL SPRINGS FL
33065-4165
US

IV. Provider business mailing address

719 SW 79TH AVE
NORTH LAUDERDALE FL
33068-2244
US

V. Phone/Fax

Practice location:
  • Phone: 954-231-8700
  • Fax: 954-231-8707
Mailing address:
  • Phone: 954-231-8700
  • Fax: 954-231-8707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATINA P DAVIS-KENNEDY
Title or Position: OWNER AND PROVIDER
Credential: DNP, FNP, PMHNP-BC
Phone: 954-231-8700