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General NPI Number Information
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NPI Number | 1891509790
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Entity Type | Organization
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Legal Business Name | SOUTHWELL HEALTHCARE INC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1806 N FLAMINGO RD STE 347
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1040
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Country | US
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Telephone | 954-638-9197
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Fax | 800-500-1921
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Provider Business Mailing Address
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Address Line | 1806 N FLAMINGO RD STE 347
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1040
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Country | US
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Telephone | 877-354-5338
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Fax | 800-500-1921
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Authorized Official
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Title or Position | OWNER
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Name | SIRAHAYDEE PENA-ALCANTARA
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Credential | APRN
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Telephone | 717-916-8077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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