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Organization
NEW EDEN WELLNESS CENTER LLC
Active
Organization
NEW EDEN WELLNESS CENTER LLC
Active
Other names
New Eden Wellness LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GARDINE JACQUES DNP,ANP-BC,PMHNP-BC, (NURSE PRACTITIONER)
(305) 519-7951
Entity
Organization
Contact information
Practice address
3011 MARSHFIELD PRESERVE WAY, KISSIMMEE, FL 34746-2105
(305) 519-7951
Mailing address
7385 NW 68TH WAY, PARKLAND, FL 33067-3918
(305) 519-7951
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
07/29/2022
Last updated
04/16/2024
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