MEDICARE: PEACE OF THOUGHT INTEGRATIVE 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1720969876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF THOUGHT INTEGRATIVE WELLNESS LLC

Provider Business Mailing Address
First Line	:	4300 N UNIVERSITY DR STE F100
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33351-6243
Country	:	US
Telephone Number	:	469-638-3162
Fax Number	:

Provider Business Practice Location Address
First Line	:	8400 NORTH UNIVERSITY DR
Second Line	:	SUITE 319
City	:	TAMARAC
State	:	FL
Zip	:	33321
Country	:	US
Telephone Number	:	954-539-2366
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CANDACE MONDESIR
Credential	:
Telephone Number	:	469-638-3162

Provider Enumeration Date	:	09/08/2025
Last Update Date	:	03/17/2026

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