MEDICARE: PGRX WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QH0100X	Health Service Clinic/Center
2	133N00000X	Nutritionist
3	261Q00000X	Clinic/Center
4	261QP2300X	Primary Care Clinic/Center
5	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1992578611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PGRX WELLNESS

Provider Business Mailing Address
First Line	:	4501 NW 31ST AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-3403
Country	:	US
Telephone Number	:	754-223-7701
Fax Number	:	754-300-5998

Provider Business Practice Location Address
First Line	:	4501 NW 31ST AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-3403
Country	:	US
Telephone Number	:	754-223-7701
Fax Number	:	754-300-5998

Authorized Official
Title or Position	:	CEO/FUNCTIONAL MEDICINE SPECIALIST
Name	:	DR. JOELLE M MOLIERE
Credential	:	RPH, MPH, FAARFM,
Telephone Number	:	954-612-5831

Provider Enumeration Date	:	11/03/2023
Last Update Date	:	01/06/2026

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Directions to “PGRX WELLNESS ” Practice Location

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