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General NPI Number Information
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NPI Number | 1467129304
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Entity Type | Organization
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Legal Business Name | COMPLECARE WELLNESS LLC
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 9900 W SAMPLE RD STE 203-51
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4048
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Country | US
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Telephone | 954-866-0810
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Fax | 877-552-0976
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Provider Business Mailing Address
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Address Line | 8801 W ATLANTIC BLVD # 773714
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-7462
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Country | US
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Telephone | 954-866-0810
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Fax | 877-552-0946
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Authorized Official
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Title or Position | CEO/NURSE PRACTITIONER
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Name | DR. ROSELINE RAPHAEL
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Credential | DNP, PMHNP-BC,FNP-BC
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Telephone | 954-866-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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