Healthcare Provider Details

I. General information

NPI: 1225450364
Provider Name (Legal Business Name): LAINE N.P.- ADULT HEALTH WELLNESS CARE P.C. INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10452 NW 48TH MNR
CORAL SPRINGS FL
33076-1730
US

IV. Provider business mailing address

539 DE MOTT AVE
NORTH BALDWIN NY
11510-1321
US

V. Phone/Fax

Practice location:
  • Phone: 516-273-0163
  • Fax:
Mailing address:
  • Phone: 516-223-6088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberF304165-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number199824
License Number StateNY

VIII. Authorized Official

Name: ROSAIRE B LAINE
Title or Position: CEO
Credential: APN-BC
Phone: 973-220-8313