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CENTRAL FLORIDA WELLNESS LLC NPI 1275008716


NPI Information

NPI: 1275008716
Provider Name: CENTRAL FLORIDA WELLNESS LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 10D2128107

Address:
1800 W HIBISCUS BLVD STE 131
MELBOURNE, FL
ZIP 32901
Phone: (407) 226-2993
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CENTRAL FLORIDA WELLNESS LLC is a general practice in Melbourne, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CENTRAL FLORIDA WELLNESS LLC NPI is 1275008716. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1800 W HIBISCUS BLVD STE 131
MELBOURNE, FL
ZIP 32901-633
Phone: (407) 226-2993
Fax: (407) 226-2996

The provider's authorized official is Tim Shortley .
The authorized official title is Owner and has the following contact phone number (407) 226-2993.

The CLIA number assigned to this NPI record is 10D2128107 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2018 and was last updated on 10/11/2018.


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
1208D00000XGeneral PracticeYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.