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General NPI Number Information
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NPI Number | 1932096914
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Entity Type | Organization
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Legal Business Name | MIND FULL OF WELLNESS, LLC
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Dates
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Enumeration Date | 06/21/2025
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Last Update Date | 10/19/2025
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Provider Practice Location Address
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Address Line | 15707 COLLECTING CANAL RD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4235
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Country | US
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Telephone | 561-441-1158
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Fax |
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Provider Business Mailing Address
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Address Line | 15707 COLLECTING CANAL RD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4235
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Country | US
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Telephone | 561-441-1158
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER/EMPLOYEE
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Name | SHAWN MICHAEL PERRIGO
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Credential | MSN-ARNP-PMHNP-BC
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Telephone | 561-441-1158
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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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