Provider Demographics
NPI:1700534450
Name:WELLINGTON, ONIESHA T (APRN)
Entity Type:Individual
Prefix:MS
First Name:ONIESHA
Middle Name:T
Last Name:WELLINGTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3888 NW 67TH WAY
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-7309
Mailing Address - Country:US
Mailing Address - Phone:754-551-1102
Mailing Address - Fax:
Practice Address - Street 1:3888 NW 67TH WAY
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-7309
Practice Address - Country:US
Practice Address - Phone:754-551-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014401207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine