Bountiful Wellness, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

IMT1950 Issued in FL

Legal business name

BOUNTIFUL WELLNESS, LLC

Practice address

4010 Inverrary Blvd
9A
Lauderhill, FL 33319-4319

Phone

(954) 242-4988

NPI assigned

Mar 29, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Vikke Brooks Brooks, THERAPIST

Title

Director

Phone

(954) 242-4988

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1366974313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 INVERRARY BLVD",
            "address_2": "9A",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333194319",
            "telephone_number": "954-242-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 INVERRARY BLVD",
            "address_2": "9A",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333194319",
            "telephone_number": "954-242-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNTIFUL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "VIKKE",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-242-4988",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "THERAPIST"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "IMT1950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Farah Bouie, ATC
• Dana Marie Bowen-Reid, APRN
• Tikea Elgeta Bowers, MSN, RN
• Rochelle Boyd, ARNP
• Taniece La'Shay Bradford
• Bradley Simon Dcpa

• Health Maintenance Organization in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.