Healthcare Provider Details

I. General information

NPI: 1528840964
Provider Name (Legal Business Name): ALPHA WELL-BEING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24830 BURNT PINE DR STE 3
BONITA SPRINGS FL
34134-1974
US

IV. Provider business mailing address

24830 BURNT PINE DR STE 3
BONITA SPRINGS FL
34134-1974
US

V. Phone/Fax

Practice location:
  • Phone: 239-823-3197
  • Fax: 239-268-9688
Mailing address:
  • Phone: 239-823-3197
  • Fax: 239-268-9688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CARINA GOMEZ
Title or Position: OWNER
Credential:
Phone: 239-823-3179