MEDICARE: AMITIE WELLNESS INC

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	1041C0700X	Clinical Social Worker	SW13131	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5485861	OTHER	FL	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5632569	OTHER	FL	CIGNA

General Provider Information

NPI Number	:	1912372863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMITIE WELLNESS INC

Provider Business Mailing Address
First Line	:	3131 NW 68TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1232
Country	:	US
Telephone Number	:	305-310-3015
Fax Number	:	305-847-1432

Provider Business Practice Location Address
First Line	:	3131 NW 68TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1232
Country	:	US
Telephone Number	:	786-779-8898
Fax Number	:	305-847-1432

Authorized Official
Title or Position	:	OWNER
Name	:	JEANNE E ASSINTHE
Credential	:	LCSW
Telephone Number	:	305-310-3015

Provider Enumeration Date	:	12/03/2015
Last Update Date	:	12/31/2025

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Directions to “AMITIE WELLNESS INC ” Practice Location

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