Healthcare Provider Details

I. General information

NPI: 1912372863
Provider Name (Legal Business Name): AMITIE WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 NW 68TH CT
FORT LAUDERDALE FL
33309-1232
US

IV. Provider business mailing address

3131 NW 68TH CT
FORT LAUDERDALE FL
33309-1232
US

V. Phone/Fax

Practice location:
  • Phone: 786-779-8898
  • Fax: 305-847-1432
Mailing address:
  • Phone: 305-310-3015
  • Fax: 305-847-1432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13131
License Number StateFL

VIII. Authorized Official

Name: JEANNE E ASSINTHE
Title or Position: OWNER
Credential: LCSW
Phone: 305-310-3015