Healthcare Provider Details

I. General information

NPI: 1326757204
Provider Name (Legal Business Name): ACCESS WELLNESS HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2022
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SW VISION GLN
LAKE CITY FL
32025-1111
US

IV. Provider business mailing address

5915 SW 49TH AVE
OCALA FL
34474-5701
US

V. Phone/Fax

Practice location:
  • Phone: 386-755-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: UMESH MHATRE
Title or Position: CHAIRMAN
Credential:
Phone: 386-755-1800