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General NPI Number Information
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NPI Number | 1881572238
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Entity Type | Organization
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Legal Business Name | DIVINE WELLNESS PARTNERS, LLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 4680 LIPSCOMB ST NE STE 10B
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City | PALM BAY
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State | FL
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Zip | 32905-2928
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Country | US
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Telephone | 321-364-3758
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Fax | 833-635-8722
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Provider Business Mailing Address
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Address Line | 4680 LIPSCOMB ST NE STE 10B
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City | PALM BAY
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State | FL
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Zip | 32905-2928
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Country | US
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Telephone | 321-364-3758
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Fax | 833-635-8722
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | MRS. TIFFANY JAMES
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Credential | APRN, FNP-C, BCPA
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Telephone | 321-364-3758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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