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General NPI Number Information
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NPI Number | 1952186041
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Entity Type | Organization
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Legal Business Name | PROSPER HEALTH & WELLNESS, LLC.
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 1400 CORPORATE CENTER WAY STE 120
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City | WELLINGTON
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State | FL
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Zip | 33414-2210
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Country | US
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Telephone | 561-850-4308
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Fax | 561-925-5808
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Provider Business Mailing Address
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Address Line | 13129 68TH ST N
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-1932
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Country | US
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Telephone | 177-280-1954
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DEANNA GOULET
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Credential | APRN
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Telephone | 772-801-9548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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