Provider Demographics
NPI:1659085413
Name:ELITE HEALTH CARE AND WELLNESS SERVICES
Entity Type:Organization
Organization Name:ELITE HEALTH CARE AND WELLNESS SERVICES
Other - Org Name:ELITE HEALTH CARE AND WELLNESS SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORE
Authorized Official - Middle Name:
Authorized Official - Last Name:JESUCA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:561-674-2881
Mailing Address - Street 1:8736 ESCONDIDO WAY E
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2511
Mailing Address - Country:US
Mailing Address - Phone:561-674-2881
Mailing Address - Fax:
Practice Address - Street 1:345-347 W 27TH AVENUE
Practice Address - Street 2:
Practice Address - City:FORT-LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312
Practice Address - Country:US
Practice Address - Phone:561-674-2881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty