Healthcare Provider Details

I. General information

NPI: 1164386843
Provider Name (Legal Business Name): WELLNESS WAY SOUTH SARASOTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 MARQUESAS CIR STE 105
SARASOTA FL
34233-3343
US

IV. Provider business mailing address

5602 MARQUESAS CIR STE 105
SARASOTA FL
34233-3343
US

V. Phone/Fax

Practice location:
  • Phone: 941-390-0525
  • Fax: 941-390-0526
Mailing address:
  • Phone: 941-390-0525
  • Fax: 941-390-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: CANAAN ANDREWS
Title or Position: OWNER
Credential: DC
Phone: 770-354-8415