MEDICARE: ASHA WELLNESS 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	261QP2000X	Physical Therapy Clinic/Center	CH7931	FL

General Provider Information

NPI Number	:	1548790108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHA WELLNESS LLC

Provider Business Mailing Address
First Line	:	8287 N PINE ISLAND RD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1541
Country	:	US
Telephone Number	:	954-722-6637
Fax Number	:	954-720-6298

Provider Business Practice Location Address
First Line	:	8287 N PINE ISLAND RD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1541
Country	:	US
Telephone Number	:	954-722-6637
Fax Number	:	954-720-6298

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ROXANN FRYE
Credential	:
Telephone Number	:	954-722-6637

Provider Enumeration Date	:	06/15/2017
Last Update Date	:	07/21/2022

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Directions to “ASHA WELLNESS LLC ” Practice Location

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