Healthcare Provider Details

I. General information

NPI: 1013873249
Provider Name (Legal Business Name): ASHLEY ROEQUEL WELCOME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 INDUSTRIAL DR
DELAND FL
32724-2039
US

IV. Provider business mailing address

1991 INDUSTRIAL DRIVE
DELAND FL
32724
US

V. Phone/Fax

Practice location:
  • Phone: 888-803-8101
  • Fax: 877-508-0655
Mailing address:
  • Phone: 888-803-8101
  • Fax: 877-508-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025032213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: