| My Wellness Practice | |
|
12505 Orange Dr Ste 905 Davie FL 33330-4300 | |
| (954) 839-6002 | |
| (954) 539-6002 |
| Full Name | My Wellness Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 12505 Orange Dr Ste 905, Davie, Florida |
| Authorized Official Name and Position | Sumaira Jagvani (OWNER) |
| Authorized Official Contact | 9544394333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Wellness Practice 12505 Orange Dr Ste 905 Davie FL 33330-4300 Ph: (954) 839-6002 | My Wellness Practice 12505 Orange Dr Ste 905 Davie FL 33330-4300 Ph: (954) 839-6002 |
| NPI Number | 1710734975 |
|---|---|
| Provider Enumeration Date | 05/03/2024 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 9133661374 |
|---|---|
| Medicare Enrollment ID | O20240604000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710734975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sumaira Jagvani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740826692 PECOS PAC ID: 5395174940 Enrollment ID: I20200401003135 |
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