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Organization

BODY & MIND WORKS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONELLE RIVAS-GIBSON (NURSE PRACTITIONER)
(954) 900-9804
Entity
Organization

Contact information

Practice address
1600 N STATE ROAD 7, LAUDERHILL, FL 33313-5853
(954) 554-3454
Mailing address
1600 N STATE ROAD 7, LAUDERHILL, FL 33313-5853

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
10/22/2019
Last updated
10/22/2019
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