MEDICARE: ROOTED LOVE LLC DBA ANGELS IN SCRUBS CONCIERGE

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	364SH1100X	Holistic Clinical Nurse Specialist

General Provider Information

NPI Number	:	1497699920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTED LOVE LLC DBA ANGELS IN SCRUBS CONCIERGE

Provider Business Mailing Address
First Line	:	524 GRAND CLUB PL
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-8126
Country	:	US
Telephone Number	:	718-678-6998
Fax Number	:

Provider Business Practice Location Address
First Line	:	524 GRAND CLUB PL
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-8126
Country	:	US
Telephone Number	:	718-678-6998
Fax Number	:

Authorized Official
Title or Position	:	LPN
Name	:	CASSANDRA CHARLEMAGNE
Credential	:	LPN
Telephone Number	:	718-678-6998

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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