Organization
WELLNESS 4 LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELAINE ROACH (PRESIDENT/CEO)
(954) 367-6192
Entity
Organization
Contact information
Practice address
9680 PINES BLVD, N/A, PEMBROKE PINES, FL 33024-6246
(954) 367-6192
(954) 342-9624
Mailing address
PO BOX 170084, HIALEAH, FL 33017-0084
(954) 367-6192
(954) 342-9624
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
ND4061
FL
Other
Enumeration date
01/29/2009
Last updated
10/20/2016
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