Organization
GAIA GROVE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA VILLASUSO APRN (OWNER)
(305) 934-8460
Entity
Organization
Contact information
Practice address
8315 SW 24TH ST, MIAMI, FL 33155-1138
(305) 934-8460
Mailing address
10521 SW 88TH ST STE E106, MIAMI, FL 33176-1554
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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