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General NPI Number Information
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NPI Number | 1164448197
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Entity Type | Organization
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Legal Business Name | FLORIDA COMPLETE WELLNESS, INC.
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 3408 W 84TH ST STE 309
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4944
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Country | US
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Telephone | 954-765-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 3408 W 84TH ST STE 309
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4944
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Country | US
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Telephone | 954-765-6505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARRAR VALINE DURO
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Credential |
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Telephone | 954-765-6505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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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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