Healthcare Provider Details

I. General information

NPI: 1376200113
Provider Name (Legal Business Name): ALL TOGETHER WELLNESS ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2021
Last Update Date: 11/28/2021
Certification Date: 11/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14286 BEACH BLVD STE 19-222
JACKSONVILLE FL
32250-1561
US

IV. Provider business mailing address

14286 BEACH BLVD STE 19-222
JACKSONVILLE FL
32250-1561
US

V. Phone/Fax

Practice location:
  • Phone: 904-450-5061
  • Fax: 866-730-7983
Mailing address:
  • Phone: 904-450-5061
  • Fax: 866-730-7983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER QUARTANO
Title or Position: OWNER
Credential: PT
Phone: 904-450-5061