The Ark Nutrition and Wellness Center

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

PA9109573 Issued in FL

Legal business name

THE ARK NUTRITION AND WELLNESS CENTER

Practice address

1960 NE 47TH St Ste 102
Ft Lauderdale, FL 33308-7708

Phone

(954) 888-8335

NPI assigned

Apr 19, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Gothelf, PA-C

Title

Physician Assistant

Phone

(954) 888-8335

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1417481250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 NE 47TH ST STE 102",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087708",
            "telephone_number": "954-888-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 NE 47TH ST STE 102",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087708",
            "telephone_number": "954-888-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARK NUTRITION AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "GOTHELF",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "954-888-8335",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "PA9109573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.