Healthcare Provider Details

I. General information

NPI: 1265366124
Provider Name (Legal Business Name): GRACE & CO CONCIERGE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5358 SW 183RD AVE
MIRAMAR FL
33029-6311
US

IV. Provider business mailing address

5358 SW 183RD AVE
MIRAMAR FL
33029-6311
US

V. Phone/Fax

Practice location:
  • Phone: 954-574-7963
  • Fax:
Mailing address:
  • Phone: 954-574-7963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: LISA ANTONNETTE MARSHALL
Title or Position: FOUNDER
Credential: RN
Phone: 954-574-7963