Healthcare Provider Details

I. General information

NPI: 1619852233
Provider Name (Legal Business Name): ELITE HEALTH CARE AND WELLNESS COMMUNITY MENTAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 W OAKLAND PARK BLVD STE 304B
SUNRISE FL
33351-6741
US

IV. Provider business mailing address

345 SW 27TH AVE
FORT LAUDERDALE FL
33312-2050
US

V. Phone/Fax

Practice location:
  • Phone: 954-304-9770
  • Fax: 954-304-9775
Mailing address:
  • Phone: 954-304-9770
  • Fax: 954-304-9775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: FLORE MARIE JESUCA
Title or Position: OWNER
Credential:
Phone: 561-674-2881