MEDICARE: ASCEND MIND AND BODY OF WESLEY CHAPEL 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1295698751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCEND MIND AND BODY OF WESLEY CHAPEL LLC

Provider Business Mailing Address
First Line	:	832 S FLORIDA AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-5202
Country	:	US
Telephone Number	:	813-670-3005
Fax Number	:	844-548-7006

Provider Business Practice Location Address
First Line	:	3971 MORAN RD STE 101
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4631
Country	:	US
Telephone Number	:	813-670-3005
Fax Number	:	844-548-7006

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS DEV. & OPS
Name	:	SHAUNA HORN
Credential	:
Telephone Number	:	656-237-7722

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

Similar Medicare Providers

1609738798 — TRIUNITY WELLNESS LLC
Practice Location Address:

3971 MORAN RD STE 102
TAMPA, FL
33618-4631

Practice Phone: 813-908-0675
Practice Fax: 813-558-5971

1548607716 — NETWORK SYNERGY GROUP, INC.
Practice Location Address:

4631 WOODLAND CORPORATE BLVD , SUITE 310
TAMPA, FL
33614-2442

Practice Phone: 813-207-0727
Practice Fax: 813-282-0557

1487189221 — JILLIAN GENEVIEVE GOLES PA-C
Practice Location Address:

4631 WOODLAND CORPORATE BLVD
TAMPA, FL
33614-2442

Practice Phone: 410-960-9108
Practice Fax:

1932824224 — BLUEBIRD THERAPY CENTER, LLC
Practice Location Address:

5206 HALIFAX DR
TAMPA, FL
33615-4631

Practice Phone: 954-805-2559
Practice Fax:

1225926801 — CAROLINE GERARD MS, LDN, RDN
Practice Location Address:

4631 WOODLAND CORPORATE BLVD
TAMPA, FL
33614-2442

Practice Phone: 727-342-0796
Practice Fax:

1053203604 — HEALTH MAP MEDICAL, PLLC
Practice Location Address:

4631 WOODLAND CORPORATE BLVD STE 201
TAMPA, FL
33614-2440

Practice Phone: 877-546-7004
Practice Fax:

Directions to “ASCEND MIND AND BODY OF WESLEY CHAPEL LLC ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.