MEDICARE: DR. DENISE FARRELL PHD

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	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1639068661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE FARRELL PHD

Provider Business Mailing Address
First Line	:	1801 SW 1ST AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-2124
Country	:	US
Telephone Number	:	615-593-7189
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 SW 1ST AVE APT 410
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-2155
Country	:	US
Telephone Number	:	615-593-7189
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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