Healthcare Provider Details

I. General information

NPI: 1699690826
Provider Name (Legal Business Name): HOLISTIC AYUQI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4387 N UNIVERSITY DR
SUNRISE FL
33351-6211
US

IV. Provider business mailing address

8001 NW 66TH TER
TAMARAC FL
33321-7015
US

V. Phone/Fax

Practice location:
  • Phone: 954-519-8971
  • Fax:
Mailing address:
  • Phone: 954-519-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SYDIA SPENCE
Title or Position: FNP-C
Credential:
Phone: 954-519-8971