# GAIA GROVE WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699649681
- **Authorized official:** ANNA VILLASUSO APRN (OWNER)
- **Authorized official phone:** (305) 934-8460

## Contact information

- **Practice address:** 8315 SW 24TH ST, MIAMI, FL 33155-1138
- **Practice address phone:** (305) 934-8460
- **Mailing address:** 10521 SW 88TH ST STE E106, MIAMI, FL 33176-1554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | Yes |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/02/2025
- **Last updated:** 10/02/2025