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General NPI Number Information
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NPI Number | 1225847288
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Entity Type | Organization
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Legal Business Name | PRISMA WELLNESS FLORIDA LLC
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Dates
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Enumeration Date | 01/04/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 1270 ORANGE AVE STE D3
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City | WINTER PARK
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State | FL
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Zip | 32789-4946
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Country | US
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Telephone | 206-785-1015
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Fax | 206-785-1023
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Provider Business Mailing Address
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Address Line | 1270 ORANGE AVE STE D3
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City | WINTER PARK
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State | FL
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Zip | 32789-4946
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Country | US
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Telephone | 206-785-1015
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Fax | 206-939-1023
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Authorized Official
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Title or Position | OWNER
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Name | DANIELA BORQUEZ
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Credential |
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Telephone | 206-939-1456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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