MEDICARE: NURTRIX TOTAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1043179898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURTRIX TOTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	12794 FOREST HILL BLVD STE 9-1010A
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4710
Country	:	US
Telephone Number	:	786-771-9055
Fax Number	:

Provider Business Practice Location Address
First Line	:	12794 FOREST HILL BLVD STE 9-1010A
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4710
Country	:	US
Telephone Number	:	786-771-9055
Fax Number	:

Authorized Official
Title or Position	:	AUTTHORIZED OFFICIAL
Name	:	FEDNA LINDOR
Credential	:	AGACNP-BC
Telephone Number	:	954-793-8957

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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