Healthcare Provider Details

I. General information

NPI: 1265857403
Provider Name (Legal Business Name): NU-ME FITNESS AND EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 02/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 N WICKHAM RD SUITE 9
MELBOURNE FL
32935-2322
US

IV. Provider business mailing address

3150 N WICKHAM RD SUITE 9
MELBOURNE FL
32935-2322
US

V. Phone/Fax

Practice location:
  • Phone: 386-479-6620
  • Fax: 321-241-6443
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME42998
License Number StateFL

VIII. Authorized Official

Name: DR. THOMAS K VELLEFF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 386-479-6620