Healthcare Provider Details

I. General information

NPI: 1205438090
Provider Name (Legal Business Name): THE LADY WELL CONSULTING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N ORANGE AVE APT 910
ORLANDO FL
32801-1553
US

IV. Provider business mailing address

7401 4TH ST N STE 5728
ST PETERSBURG FL
33702-5407
US

V. Phone/Fax

Practice location:
  • Phone: 904-333-9152
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TALONDA BRYANT
Title or Position: OWNER, FOUNDER, CEO
Credential: PT, DPT
Phone: 904-321-9287