MEDICARE: SLIMFIT WELLNESS CLINIC

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1598635252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLIMFIT WELLNESS CLINIC

Provider Business Mailing Address
First Line	:	8816 UNIVERSITY EAST DR STE A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-4109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8816 UNIVERSITY EAST DR STE A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-4109
Country	:	US
Telephone Number	:	980-777-4777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOUNGES DESSALINES
Credential	:
Telephone Number	:	980-777-4777

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	11/07/2025

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