Healthcare Provider Details

I. General information

NPI: 1982519963
Provider Name (Legal Business Name): IVEMED HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 W REYNOLDS ST STE 104
PLANT CITY FL
33563-4737
US

IV. Provider business mailing address

7364 KATHLEEN RD # 1026
LAKELAND FL
33810-4495
US

V. Phone/Fax

Practice location:
  • Phone: 863-225-2471
  • Fax: 863-583-9934
Mailing address:
  • Phone: 863-225-2471
  • Fax: 863-583-9934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: IVELISSE CRUZ
Title or Position: PCP
Credential: APRN
Phone: 863-934-1270