Healthcare Provider Details

I. General information

NPI: 1972275634
Provider Name (Legal Business Name): TRICIA HALL-WELLINGTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 05/27/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3609
US

IV. Provider business mailing address

11521 SW 10TH CT
PEMBROKE PINES FL
33025-4342
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN11014785
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: