Healthcare Provider Details

I. General information

NPI: 1205562709
Provider Name (Legal Business Name): PRIORITY WELLNESS CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 N ANDREWS AVE STE 200
LAUDERDALE LAKES FL
33309-2180
US

IV. Provider business mailing address

6750 N ANDREWS AVE STE 200
LAUDERDALE LAKES FL
33309-2180
US

V. Phone/Fax

Practice location:
  • Phone: 786-350-5503
  • Fax:
Mailing address:
  • Phone: 786-350-5503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ALICIA DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 786-350-5503