Healthcare Provider Details
I. General information
NPI: 1811390750
Provider Name (Legal Business Name): HEALTHSTAT WELLNESS , INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2014
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8606 GOVERNMENT DR STE 3
NEW PORT RICHEY FL
34654-5510
US
IV. Provider business mailing address
10 W MARKET ST STE 2900
INDIANAPOLIS IN
46204-2964
US
V. Phone/Fax
- Phone: 727-816-1520
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0500X |
| Taxonomy | Preventive Medicine/Occupational Environmental Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TOBIAS
D.
BARKER
Title or Position: PRESIDENT
Credential: MD
Phone: 781-366-1655