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General NPI Number Information
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NPI Number | 1346138583
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Entity Type | Organization
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Legal Business Name | MY WELLNESS JOURNEE LLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 3900 WOODLAKE BLVD STE 200-18
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City | GREENACRES
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State | FL
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Zip | 33463-3044
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Country | US
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Telephone | 561-203-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 WOODLAKE BLVD STE 200-18
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City | GREENACRES
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State | FL
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Zip | 33463-3044
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Country | US
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Telephone | 561-203-9119
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SHAWN FISHER
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Credential | PA
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Telephone | 561-203-9119
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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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