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NPI Code Detail

MEDICARE: LIVE WELL DPC

MEDICARE: LIVE WELL DPC
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1275365066
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVE WELL DPC
Provider Business Mailing Address
First Line : 1528 S TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-2607
Country : US
Telephone Number : 941-529-7770
Fax Number : 941-529-7775
Provider Business Practice Location Address
First Line : 1528 S TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-2607
Country : US
Telephone Number : 941-529-7770
Fax Number : 941-529-7775
Authorized Official
Title or Position : MANAGER
Name : JULIE DOOLEY
Credential : APRN
Telephone Number : 941-529-7770
Provider Enumeration Date : 08/19/2024
Last Update Date : 08/19/2024

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Directions to “LIVE WELL DPC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.