Healthcare Provider Details

I. General information

NPI: 1306542188
Provider Name (Legal Business Name): WELCOME TO WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2023
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 OLD HICKORY TREE RD STE 107
SAINT CLOUD FL
34772-8901
US

IV. Provider business mailing address

2090 OLD HICKORY TREE RD STE 107
SAINT CLOUD FL
34772-8901
US

V. Phone/Fax

Practice location:
  • Phone: 516-316-2032
  • Fax: 352-353-4717
Mailing address:
  • Phone: 516-316-2032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: RENEE BOCCIO
Title or Position: OWNER
Credential: DC
Phone: 516-316-2032