Healthcare Provider Details
I. General information
NPI: 1558127506
Provider Name (Legal Business Name): LAMBERT WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9990 COCONUT RD STE 324
ESTERO FL
34135-8488
US
IV. Provider business mailing address
9990 COCONUT RD STE 324
ESTERO FL
34135-8488
US
V. Phone/Fax
- Phone: 239-248-6079
- Fax: 239-444-1995
- Phone: 239-248-6079
- Fax: 239-444-1995
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP3300X |
| Taxonomy | Pain Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
LAMBERT
Title or Position: OWNER/OPERATOR
Credential: LMT, LE
Phone: 239-776-4055