Healthcare Provider Details

I. General information

NPI: 1255344784
Provider Name (Legal Business Name): VALERIE WELLS APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE JACKSON MEMORIAL HOSPITAL - DTC 316 E
MIAMI FL
33136-1005
US

IV. Provider business mailing address

11851 SW 51ST ST
COOPER CITY FL
33330-4413
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-8508
  • Fax:
Mailing address:
  • Phone: 305-585-8508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number2089632
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN2089632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: