Healthcare Provider Details

I. General information

NPI: 1952926982
Provider Name (Legal Business Name): WELLNOS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4490 N UNIVERSITY DR
LAUDERHILL FL
33351-4513
US

IV. Provider business mailing address

4490 N UNIVERSITY DR
LAUDERHILL FL
33351-4513
US

V. Phone/Fax

Practice location:
  • Phone: 754-701-7274
  • Fax: 954-453-6065
Mailing address:
  • Phone: 954-578-4443
  • Fax: 954-578-4868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD A HENRY
Title or Position: OWNER
Credential: DC
Phone: 954-578-4443