Healthcare Provider Details

I. General information

NPI: 1700511979
Provider Name (Legal Business Name): BE WELL HOLISTIC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 E JACKSON ST
ORLANDO FL
32801-2805
US

IV. Provider business mailing address

417 E JACKSON ST
ORLANDO FL
32801-2805
US

V. Phone/Fax

Practice location:
  • Phone: 407-494-2272
  • Fax:
Mailing address:
  • Phone: 407-494-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA K SONNENSCHEIN
Title or Position: MANAGING MEMBER
Credential:
Phone: 407-494-2272