MEDICARE: WEIGHT AND BODY SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	111N00000X	Chiropractor
2	225100000X	Physical Therapist
3	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1063951135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEIGHT AND BODY SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	5414 TOWN N COUNTRY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4120
Country	:	US
Telephone Number	:	813-886-4395
Fax Number	:	813-886-6959

Provider Business Practice Location Address
First Line	:	5414 TOWN N COUNTRY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4120
Country	:	US
Telephone Number	:	813-886-4395
Fax Number	:	813-886-6959

Authorized Official
Title or Position	:	CEO
Name	:	HILDA OBI-ANADIUME
Credential	:	RN
Telephone Number	:	813-886-4395

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	08/28/2018

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