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General NPI Number Information
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NPI Number | 1013598358
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Entity Type | Organization
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Legal Business Name | 365 WELLNESS
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 7611 SANTEE TER
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City | LAKE WORTH
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State | FL
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Zip | 33467-7866
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Country | US
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Telephone | 561-770-8072
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Fax |
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Provider Business Mailing Address
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Address Line | 7611 SANTEE TER
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City | LAKE WORTH
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State | FL
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Zip | 33467-7866
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Country | US
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Telephone | 195-443-9063
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | ROSHINI SINGH
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Credential | APRN
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Telephone | 954-439-0633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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