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General NPI Number Information
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NPI Number | 1083322994
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Entity Type | Organization
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Legal Business Name | THE WELLNESS NPS
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 17900 NW 5TH ST STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2809
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Country | US
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Telephone | 305-766-0392
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Fax |
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Provider Business Mailing Address
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Address Line | 1142 BANYAN DR
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2135
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Country | US
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Telephone | 305-766-0392
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AISSEL FAQUIR
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Credential | DNP-APRN
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Telephone | 305-766-0392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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