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CUSTOMIZED WELLNESS LLC NPI 1790335164


NPI Information

NPI: 1790335164
Provider Name: CUSTOMIZED WELLNESS, LLC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
131 W CENTER AVENUE
SEBRING, FL
ZIP 33870
Phone: (863) 658-1764
Get Directions

CUSTOMIZED WELLNESS, LLC is a gynecology obstetrics gynecology in Sebring, FL. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee CUSTOMIZED WELLNESS, LLC NPI is 1790335164. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

131 W CENTER AVENUE
SEBRING, FL
ZIP 33870
Phone: (863) 658-1764
Fax: (855) 847-8646

The provider's authorized official is Amanda C Lucero .
The authorized official title is Owner/provider and has the following contact phone number (863) 658-1764.

The enumeration date for this NPI number is 9/17/2019 and was last updated on 9/17/2019.


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
1207VG0400XObstetrics & GynecologyGynecologyYes

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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