Healthcare Provider Details

I. General information

NPI: 1174744957
Provider Name (Legal Business Name): PARKSIDE HEALTH & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6662 PARKSIDE DR
PARKLAND FL
33067-1694
US

IV. Provider business mailing address

6662 PARKSIDE DR
PARKLAND FL
33067-1694
US

V. Phone/Fax

Practice location:
  • Phone: 954-340-7854
  • Fax: 954-340-8925
Mailing address:
  • Phone: 954-340-7854
  • Fax: 954-340-8925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8046
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH8046
License Number StateFL

VIII. Authorized Official

Name: DR. NINA C HERSCH
Title or Position: OWNER PRES
Credential: DC, FICPA
Phone: 954-340-7545