THE REFINERY MEDSPA AND WELLNES LLC NPI 1255835211

NPI Information

NPI: 1255835211
Provider Name: THE REFINERY MEDSPA AND WELLNES, LLC

Former Legal Business Name: PANACEA MEDICAL ASSOCIATES, LLC

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
4311 NORFOLK PKWY STE 114
WEST MELBOURNE, FL
ZIP 32904
Phone: (321) 722-6200
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THE REFINERY MEDSPA AND WELLNES, LLC is a health service clinic center in West Melbourne, FL. THE REFINERY MEDSPA AND WELLNES, LLC NPI is 1255835211. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Panacea Medical Associates, Llc.

The provider's business location address is:

4311 NORFOLK PKWY STE 114
WEST MELBOURNE, FL
ZIP 32904-617
Phone: (321) 722-6200

The provider's authorized official is Jarrod James Stoldt .
The authorized official title is President and has the following contact phone number (321) 917-2217.

The enumeration date for this NPI number is 3/22/2018 and was last updated on 3/22/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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