CONCIERGENP WELLNESS CENTER NPI 1760096135

NPI Information

  • NPI: 1760096135
  • Provider Name: CONCIERGENP WELLNESS CENTER
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 10D2215157
  • Address: 1001 N FEDERAL HWY STE 200
    HALLANDALE BEACH, FL
    ZIP 33009
  • Phone: (754) 444-9173

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NPI Details

CONCIERGENP WELLNESS CENTER is a primary care nurse practitioner in Hallandale Beach, FL. CONCIERGENP WELLNESS CENTER NPI is 1760096135. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1001 N FEDERAL HWY STE 200
HALLANDALE BEACH, FL
ZIP 33009-416
Phone: (754) 444-9173

The provider's authorized official is Bethany L Ellis .
The authorized official title is Nurse Practitioner and has the following contact phone number (954) 684-5493.

The CLIA number assigned to this NPI record is 10D2215157 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/3/2020 and was last updated on 1/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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