Healthcare Provider Details

I. General information

NPI: 1821909094
Provider Name (Legal Business Name): THYROID ENDOCRINE DIABETES HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SW 129TH AVE STE 109
PEMBROKE PINES FL
33027-1716
US

IV. Provider business mailing address

8403 PINES BLVD UNIT 1230
PEMBROKE PINES FL
33024-6609
US

V. Phone/Fax

Practice location:
  • Phone: 954-833-7409
  • Fax: 954-482-9086
Mailing address:
  • Phone: 954-833-7409
  • Fax: 954-482-9086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: REANNA RAMKHELAWAN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 786-281-2398