Healthcare Provider Details

I. General information

NPI: 1730550864
Provider Name (Legal Business Name): XCEL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2015
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8936 77TH TER E STE 103
LAKEWOOD RANCH FL
34202-6419
US

IV. Provider business mailing address

8936 77TH TER E STE 103
LAKEWOOD RANCH FL
34202-6419
US

V. Phone/Fax

Practice location:
  • Phone: 941-718-5077
  • Fax:
Mailing address:
  • Phone: 941-718-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. XAVIER SEVILLA
Title or Position: SOLE MEMBER
Credential: MD
Phone: 941-718-5077