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General NPI Number Information
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NPI Number | 1356940431
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Entity Type | Organization
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Legal Business Name | DR. KATINA HEALTH AND WELLNESS, INC
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 2901 CORAL HILLS DR STE 330
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4165
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Country | US
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Telephone | 954-231-8700
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Fax | 954-231-8707
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Provider Business Mailing Address
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Address Line | 1204 SANTA CATALINA LN
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-6311
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Country | US
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Telephone | 954-231-8700
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Fax | 954-231-8707
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Authorized Official
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Title or Position | OWNER
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Name | MISS KATINA P DAVIS-KENNEDY
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Credential |
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Telephone | 954-231-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 363LP2300X
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Taxonomy Name | Primary Care 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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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