Healthcare Provider Details

I. General information

NPI: 1376289082
Provider Name (Legal Business Name): WW WELLNESS ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 SW 181ST WAY
MIRAMAR FL
33029-5222
US

IV. Provider business mailing address

17113 MIRAMAR PKWY # 4
MIRAMAR FL
33027-4565
US

V. Phone/Fax

Practice location:
  • Phone: 786-371-6092
  • Fax:
Mailing address:
  • Phone: 786-371-6092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDITH WAFE
Title or Position: NURSE PRACTITIONER/FOUNDER
Credential: DNP, APRN, WHNP-BC
Phone: 786-371-6092