Healthcare Provider Details

I. General information

NPI: 1073460762
Provider Name (Legal Business Name): LENA S ASHFAQUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 SW 5TH CT
POMPANO BEACH FL
33060
US

IV. Provider business mailing address

9411 NW 46TH ST
SUNRISE FL
33351-5107
US

V. Phone/Fax

Practice location:
  • Phone: 954-805-7585
  • Fax:
Mailing address:
  • Phone: 954-702-2884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: