Provider Demographics
NPI:1700270659
Name:WAFE, JUDITH (DNP, APRN, WHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:WAFE
Suffix:
Gender:F
Credentials:DNP, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 PINES BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6422
Mailing Address - Country:US
Mailing Address - Phone:954-228-3676
Mailing Address - Fax:813-543-9657
Practice Address - Street 1:9050 PINES BLVD STE 302
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6422
Practice Address - Country:US
Practice Address - Phone:813-344-4534
Practice Address - Fax:813-543-9657
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9236294363LP0808X
FLAPRN9236294363LW0102X, 363L00000X
FLARNP 9236294367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015963900Medicaid
NH3132707Medicaid