Provider Demographics
NPI:1700654852
Name:HEALTH TRACK FITNESS AND WELLNESS,LLC
Entity Type:Organization
Organization Name:HEALTH TRACK FITNESS AND WELLNESS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:LATIMORE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,APRN,FNP,BC
Authorized Official - Phone:305-588-8049
Mailing Address - Street 1:11041 SOUTHERN BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4242
Mailing Address - Country:US
Mailing Address - Phone:561-379-8024
Mailing Address - Fax:
Practice Address - Street 1:11041 SOUTHERN BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4242
Practice Address - Country:US
Practice Address - Phone:561-379-8024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty