Healthcare Provider Details

I. General information

NPI: 1578387890
Provider Name (Legal Business Name): MS. TAMESHIA LAQUANDA SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11625 PINKSTON DR
MIAMI FL
33176-7362
US

IV. Provider business mailing address

11625 PINKSTON DR
MIAMI FL
33176-7362
US

V. Phone/Fax

Practice location:
  • Phone: 786-246-2247
  • Fax:
Mailing address:
  • Phone: 786-246-2247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: