WELLSPRING PRESERVATION MEDICAL VACATION BOUTIQUE & SPA, LLC (NPI# 1306301635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306301635 |
| Entity Type | Organization |
| Organization Name | WELLSPRING PRESERVATION MEDICAL VACATION BOUTIQUE & SPA, LLC |
| Practice Address |
14051 Sw 152nd Ter Miami FL 33177-0910 |
| Practice Telephone | 7862619088 |
| Mailing Telephone | 7862619088 |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |
| Authorized Official Name | MS. SOPHIA M FERGUSON (AGACNP-BC) |
| Authorized Official Telephone | 7862619088 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14051 Sw 152nd Terrace, Miami, FL 33177 | 7862619088 |
| Street Address |
14051 SW 152ND TER |
| City | MIAMI |
| State | FL |
| Zip Code | 33177-0910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396369351 | Damaris Perez Bobey | Behavior Technician | 13755 Sw 181 St, Miami, FL 33177 | 2020-06-04 |
| 1881232221 | South Kendall Dentistry, Pa | Dentist | 15201 Sw 127th Ave., Suite 3, Miami, FL 33177 | 2019-12-17 |
| 1538710314 | Angela Moreno | Behavior Technician | 20155 Sw 129 Ave, Miami, FL 33177 | 2019-09-24 |
| 1811473317 | Life Residential LLC | Assisted Living Facility | 13431 S.w. 178 St., Miami, FL 33177 | 2018-07-17 |
| 1639655863 | Jose Martin Jacobo Remedios | Non-emergency Medical Transport (VAN) | 11825 Sw 208th Ter, Miami, FL 33177 | 2018-07-11 |
| 1497258867 | Yanet Arias Ramirez | Behavior Technician | 12301 Sw 191 St, Miami, FL 33177 | 2018-03-13 |
| 1558876003 | Dalina Maria Blanco I | Behavior Technician | 15982 Sw 138th Ct, Miami, FL 33177 | 2017-12-06 |
| 1679082119 | Esperanza's Alf, Inc. | Assisted Living Facility | 14336 Sw 172 St., Miami, FL 33177 | 2017-09-27 |
| 1720506553 | Ledys Cagigas | Behavioral Analyst | 14430 Sw 180th St, Miami, FL 33177 | 2017-08-31 |
| 1073031043 | Mary Celeste Da Gama-freites | Behavior Technician | 13249 Sw 200 Terrace, Miami, FL 33177 | 2017-08-30 |
| Find all providers in zip 33177 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1477167799 | Yanet Moreda Mendez | Nurse Practitioner | 14433 Sw 107th Ter, Miami, FL 33186-2938 | 2020-09-03 |
| 1386285732 | Addys Lisette Santos Hernandez | Nurse Practitioner | 11031 Sw 51st Ter, Miami, FL 33165-6902 | 2019-10-07 |
| 1649736745 | Marie Aliene Jusma | Nurse Practitioner | 1095 Nw 110th Street, House, Miami, FL 33168 | 2019-02-13 |
| 1174005250 | Julieth Andrea Rave | Nurse Practitioner | 3663 S Miami Ave Ste 209, Miami, FL 33133-4253 | 2018-09-05 |
| 1245712686 | Donna O Martinez | Nurse Practitioner | 16543 Sw 59th Ter, Miami, FL 33193-5686 | 2018-09-01 |
| 1033695465 | Carolina Elena Navarro | Nurse Practitioner | 353 Sw 23rd Rd, Miami, FL 33129-1923 | 2018-07-18 |
| 1528554003 | Ernesto Gregorio Napoles | Nurse Practitioner | 14909 Sw 80th St Apt 204, Miami, FL 33193-3149 | 2018-07-08 |
| 1518451509 | Ailyn Miguel | Nurse Practitioner | 2601 Sw 37th Ave # 100, Miami, FL 33133-2700 | 2018-06-21 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.