Healthcare Provider Details

I. General information

NPI: 1992304216
Provider Name (Legal Business Name): UNITY ADVANCED HEALTHCARE AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
LAKE PARK FL
33403-2503
US

IV. Provider business mailing address

701 PARK AVE
LAKE PARK FL
33403-2503
US

V. Phone/Fax

Practice location:
  • Phone: 561-301-8675
  • Fax: 949-703-7886
Mailing address:
  • Phone: 561-301-8675
  • Fax: 561-223-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARIE RACHEL PREVILUS
Title or Position: ADMINISTRATOR
Credential: APRN
Phone: 561-301-8675