Provider Demographics
NPI:1679106462
Name:HEALTH360 LLC
Entity type:Organization
Organization Name:HEALTH360 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:AYITI
Authorized Official - Last Name:NAU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AAPRN, FNP-C
Authorized Official - Phone:954-800-0097
Mailing Address - Street 1:7777 DAVIE ROAD EXT STE 302A-4
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2513
Mailing Address - Country:US
Mailing Address - Phone:954-800-0097
Mailing Address - Fax:563-204-6014
Practice Address - Street 1:7777 DAVIE ROAD EXT STE 302A-4
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2513
Practice Address - Country:US
Practice Address - Phone:954-800-0097
Practice Address - Fax:563-204-6014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care