INTENTIONALLY WELL LLC NPI 1922426402

NPI Information

NPI: 1922426402
Provider Name: INTENTIONALLY WELL, LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
3716 SW MOORE ST
PALM CITY, FL
ZIP 34990
Phone: (772) 215-9946
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INTENTIONALLY WELL, LLC is a family nurse practitioner in Palm City, FL. INTENTIONALLY WELL, LLC NPI is 1922426402. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3716 SW MOORE ST
PALM CITY, FL
ZIP 34990-647
Phone: (772) 215-9946

The provider's authorized official is Theresa Anne Pinder .
The authorized official title is Sole Member, Ceo and has the following contact phone number (772) 215-9946.

The enumeration date for this NPI number is 4/2/2014 and was last updated on 4/2/2014.

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	207Q00000X	Family Medicine		ME69414	FLORIDA	No
2	363LF0000X	Nurse Practitioner	Family	1476272	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1912256538	OTHER		NPI

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: 11/14/2023

NPI Synchronization or Removal

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