| Moxie Wellness Center LLC | |
|
12515 Orange Dr Ste 803 Davie FL 33330-4309 | |
| (786) 975-6993 | |
| (954) 405-8541 |
| Full Name | Moxie Wellness Center LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 12515 Orange Dr Ste 803, Davie, Florida |
| Authorized Official Name and Position | Yuleisy Coto (APRN/OWNER) |
| Authorized Official Contact | 7869756993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moxie Wellness Center LLC 12515 Orange Dr Ste 803 Davie FL 33330-4309 Ph: (786) 975-6993 | Moxie Wellness Center LLC 12515 Orange Dr Ste 803 Davie FL 33330-4309 Ph: (786) 975-6993 |
| NPI Number | 1629943311 |
|---|---|
| Provider Enumeration Date | 10/10/2025 |
| Last Update Date | 11/14/2025 |
| Certification Date | 11/14/2025 |
| Medicare PECOS PAC ID | 7315423464 |
|---|---|
| Medicare Enrollment ID | O20260108003024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629943311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| 363L00000X | Nurse Practitioner | (NU) | Secondary |
| Provider Name | Yuleisy Coto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184239063 PECOS PAC ID: 8426451196 Enrollment ID: I20220504002881 |
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