MEDICARE: WECARE WELLNESS CLINIC LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1164163945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WECARE WELLNESS CLINIC LLC

Provider Business Mailing Address
First Line	:	PO BOX 1679
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33509-1679
Country	:	US
Telephone Number	:	813-438-5220
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 W BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5104
Country	:	US
Telephone Number	:	813-244-0696
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DARLYNE GEORGES
Credential	:	APRN
Telephone Number	:	813-438-5220

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	07/21/2022

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Directions to “WECARE WELLNESS CLINIC LLC ” Practice Location

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