Healthcare Provider Details

I. General information

NPI: 1295386571
Provider Name (Legal Business Name): UBUNTU INTEGRATIVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 S JOG RD STE 203
DELRAY BEACH FL
33446-2166
US

IV. Provider business mailing address

125 S STATE ROAD 7 STE 104-342
WELLINGTON FL
33414-4385
US

V. Phone/Fax

Practice location:
  • Phone: 561-289-4642
  • Fax: 561-257-1154
Mailing address:
  • Phone: 561-289-4642
  • Fax: 561-257-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANNON MAE MITCHELL
Title or Position: CEO
Credential: APN
Phone: 561-789-7771