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General NPI Number Information
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NPI Number | 1053068437
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Entity Type | Organization
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Legal Business Name | INFINITY WELLNESS CORP
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2021 E COMMERCIAL BLVD STE 308
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3769
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Country | US
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Telephone | 954-665-6417
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 E COMMERCIAL BLVD STE 308
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3769
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Country | US
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Telephone | 954-323-4484
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Fax | 954-634-5695
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN VARGHESE
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Credential | PT, DPT
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Telephone | 954-323-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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