Provider Demographics
NPI:1871341388
Name:QUBU HEALTH AND MANAGEMENT
Entity type:Organization
Organization Name:QUBU HEALTH AND MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUEENBOURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-201-1516
Mailing Address - Street 1:1230 NW LEONARDO CIR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4343
Mailing Address - Country:US
Mailing Address - Phone:501-201-1516
Mailing Address - Fax:
Practice Address - Street 1:1230 NW LEONARDO CIR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4343
Practice Address - Country:US
Practice Address - Phone:501-201-1516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty