Provider Demographics
NPI:1891546180
Name:POWER OF HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:POWER OF HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHNOZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTAMOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-391-3414
Mailing Address - Street 1:2840 S OCEAN BLVD APT 310
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-5555
Mailing Address - Country:US
Mailing Address - Phone:212-974-0490
Mailing Address - Fax:212-974-0493
Practice Address - Street 1:1025 MILITARY TRL STE 113
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7040
Practice Address - Country:US
Practice Address - Phone:561-385-1334
Practice Address - Fax:212-974-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty