Healthcare Provider Details

I. General information

NPI: 1699631861
Provider Name (Legal Business Name): PROSPER HEALTH MEDICAL SERVICES NORTHWEST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 COCONUT CIR
WESTON FL
33326-3317
US

IV. Provider business mailing address

382 COCONUT CIR
WESTON FL
33326-3317
US

V. Phone/Fax

Practice location:
  • Phone: 954-366-9978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN SCHECTER
Title or Position: AGENT
Credential:
Phone: 954-366-9978