Healthcare Provider Details

I. General information

NPI: 1134053606
Provider Name (Legal Business Name): HEAVENSSERENITY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7321 NW 35TH ST APT 4
HOLLYWOOD FL
33024-1654
US

IV. Provider business mailing address

7321 NW 35TH ST APT 4
HOLLYWOOD FL
33024-1654
US

V. Phone/Fax

Practice location:
  • Phone: 352-677-6289
  • Fax:
Mailing address:
  • Phone: 352-677-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN WILLIAMS
Title or Position: CEO
Credential:
Phone: 352-677-6289