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General NPI Number Information
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NPI Number | 1427605088
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Entity Type | Organization
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Legal Business Name | GLOBAL WELLNESS LLC
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 1560 SAWGRASS CORPORATE PARKWAY #447
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City | SUNRISE
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State | FL
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Zip | 33323
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Country | US
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Telephone | 954-494-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 5911 NE 14TH LN APT 506
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City | FORT LAUDERDALE
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State | FL
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Zip | 33334-5006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. FRANCY NATHALY FONSECCA
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Credential | PSY. D
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Telephone | 954-494-0668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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