=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053274142
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J&J PSYCHIATRIC AND MENTAL WELLNESS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4400 W SAMPLE RD STE 112E
-----------------------------------------------------
City | COCONUT CREEK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33073-3457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-795-0779
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3255 NW 94TH AVE UNIT 8575
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33075-2029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-795-0779
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ PMHNP-BC
-----------------------------------------------------
Name | WENDYLEE FLOWERS
-----------------------------------------------------
Credential | APRN, PMHNP
-----------------------------------------------------
Telephone | 954-795-0779
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------