Active NPI
Seetak Health & Wellness LLC
- Family Nurse Practitioner
- Gaithersburg, MD
National Provider Identifier
1316662190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- SEETAK HEALTH & WELLNESS LLC
- Practice address
- 937 Russell Ave Ste a
Gaithersburg, MD 20879-3280 - Phone
- (240) 477-4047
- Fax
- (240) 690-4128
- NPI assigned
- Oct 5, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Florence O Fakayode, CRNP
- Title
- Ceo/Owner
- Phone
- (240) 277-3873
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
937 Russell Ave Ste a
Gaithersburg, MD 20879-3280
Mailing address
937 Russell Ave Ste a
Gaithersburg, MD 20879-3280
Phone (240) 477-4047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R169935 | Other | MD | STATE LICENSE |
Other names 1
- New Life Wellness
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2272237 | Seetak Health & Wellness Dba New Life Wellness LLC | Certificate of waiver | Nov 15, 2026 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664928000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1664928000000",
"number": "1316662190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 RUSSELL AVE STE A",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793280",
"telephone_number": "240-477-4047",
"fax_number": "240-690-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "937 RUSSELL AVE STE A",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793280",
"telephone_number": "240-477-4047",
"fax_number": "240-690-4128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SEETAK HEALTH & WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A",
"authorized_official_last_name": "FAKAYODE",
"authorized_official_first_name": "FLORENCE",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "240-277-3873",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CRNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "R169935",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "New Life Wellness",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.