MEDICARE: HEART OF HOPE PSYCH CARE LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1073478244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF HOPE PSYCH CARE LLC

Provider Business Mailing Address
First Line	:	2111 SW 35TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3627
Country	:	US
Telephone Number	:	954-257-2601
Fax Number	:

Provider Business Practice Location Address
First Line	:	2111 SW 35TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3627
Country	:	US
Telephone Number	:	954-257-2601
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	FREDRICKA MARSH
Credential	:
Telephone Number	:	954-257-2601

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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