MEDICARE: HOLISTIC NURSING STAFFING 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1154276350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC NURSING STAFFING LLC

Provider Business Mailing Address
First Line	:	6750 N ANDREWS AVE STE 200
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-2180
Country	:	US
Telephone Number	:	754-235-8494
Fax Number	:

Provider Business Practice Location Address
First Line	:	6750 N ANDREWS AVE STE 200
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-2180
Country	:	US
Telephone Number	:	754-235-8494
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DANIELLA DERONVIL
Credential	:	RN
Telephone Number	:	754-235-8494

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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