Healthcare Provider Details

I. General information

NPI: 1487584876
Provider Name (Legal Business Name): COWELLNESS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 E BROWARD BLVD STE 301
FORT LAUDERDALE FL
33301-2046
US

IV. Provider business mailing address

5085 NW 7TH ST APT 605
MIAMI FL
33126-3454
US

V. Phone/Fax

Practice location:
  • Phone: 786-912-0609
  • Fax:
Mailing address:
  • Phone: 786-912-0609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: LENNY RENGIFO
Title or Position: OWNER-MGRM
Credential: LAC
Phone: 954-901-8263