Healthcare Provider Details

I. General information

NPI: 1396040010
Provider Name (Legal Business Name): TOTAL WELLNESS OPTIONS AND QUALITY QUICK CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 TURKEY LAKE RD SUITE 300
ORLANDO FL
32819-7383
US

IV. Provider business mailing address

8815 CONROY WINDERMERE RD SUITE 249
ORLANDO FL
32835-3129
US

V. Phone/Fax

Practice location:
  • Phone: 407-480-5353
  • Fax: 407-480-5701
Mailing address:
  • Phone: 407-451-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberME55201
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberME55201
License Number StateFL

VIII. Authorized Official

Name: DR. JENNY K YOSHIDA
Title or Position: MANAGER/MEMBER
Credential: MD
Phone: 407-451-2724