Healthcare Provider Details

I. General information

NPI: 1891408365
Provider Name (Legal Business Name): DYKAL HEALTH MANAGEMENT CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 E COMMERCIAL BLVD STE 202
FT LAUDERDALE FL
33308-4062
US

IV. Provider business mailing address

2425 E COMMERCIAL BLVD STE 202
FT LAUDERDALE FL
33308-4062
US

V. Phone/Fax

Practice location:
  • Phone: 954-408-0125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. RENEE PATRICIA GOODEN-CLARKE
Title or Position: CO-OWNER/VICE PRESIDENT
Credential: APRN, DNP
Phone: 954-684-8972